Acute renal failure requiring renal replacement therapy: incidence and outcome
Acute renal failure requiring renal replacement therapy: incidence and outcome
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DOI：
10.1093/qjmed/95.9.579
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发表时间：
2002-09-01
影响因子：
13.3
通讯作者：
MacLeod, AM
中科院分区：
文献类型：
--
作者：
Metcalfe, W;Simpson, M;MacLeod, AM
背景：急性肾功能衰竭（ARF）的肾脏替代治疗（RRT）可能在医院的许多设置提供。这类患者需要高水平的护理，通常预后较差。没有前瞻性研究准确界定这一人口，因此很难预测必要的资源和规划服务。目的：了解苏格兰需要肾替代治疗的急性肾功能衰竭的发生率、原因和预后。设计：对苏格兰三个卫生局（格兰扁区、高地、泰赛德）提供肾脏替代疗法的所有临床区域进行前瞻性观察性普查。方法：通过与每个提供RRT的单位联系来确定患者。在开始时记录导致肾功能衰竭的因素和RRT的原因。共病负担采用Charlson指数评分。根据病例记录评估患者90天的状态，必要时联系全科医生。结果：每年每百万人中有375例患者接受RRT；ARF或急性慢性肾功能衰竭的死亡率为每年百万分之203。接受RRT治疗的ARF患者中，73.5%在90天内死亡，23.5%独立于RRT治疗。住院时间中位数为19天。讨论：每年需要RRT的ARF发病率略高于200 /百万人，几乎是需要RRT的终末期肾病的两倍。这种治疗对卫生保健资源提出了很高的要求。
Background: Renal replacement therapy (RRT) for acute renal failure (ARF) may be provided in many settings within the hospital. Such patients require a high level of care and often have a poor prognosis. No prospective studies have accurately defined this population, making the prediction of necessary resources and the planning of services difficult.Aim: To ascertain the incidence, causes and outcomes of acute renal failure requiring renal replacement therapy in Scotland.Design: A prospective observational census of all clinical areas providing renal replacement therapy in three Scottish health boards (Grampian, Highland, Tayside).Methods: Patients were identified by liaison with each unit providing RRT. Factors precipitating renal failure and reasons for RRT were recorded at the time of initiation. Comorbid disease burden was scored using the Charlson index. Patient status at 90 days was assessed from case-notes, contacting general practitioners where necessary.Results: 375 patients per million population per year received RRT; 203 per million per year for either ARF or acute-on-chronic renal failure. 73.5% of patients receiving RRT for ARF died within 90 days, 23.5% became independent of RRT. The median duration of hospital admission was 19 days.Discussion: The annual incidence of ARF requiring RRT is just over 200 per million population, almost twice that of end-stage renal disease requiring RRT. Such treatment places high demands upon health care resources.