Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury
Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury
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DOI：
10.1038/ki.2011.405
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发表时间：
2012-03-01
影响因子：
19.6
通讯作者：
Perkins, Robert M.
中科院分区：
文献类型：
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作者：
Bucaloiu, Ion D.;Kirchner, H. Lester;Perkins, Robert M.
急性肾损伤会增加慢性肾病患者的死亡风险。在本研究中，我们采用倾向评分匹配队列方法，回顾性评价了住院前肾功能正常的患者发生可逆性医院相关急性肾损伤后的死亡和新发慢性肾脏疾病风险。在90天时存活的30，207例出院患者中，1610例在90天内消退的可逆性急性肾损伤患者在多个参数上与3652例未发生急性肾损伤的对照患者成功匹配。中位随访时间分别为3.3年和3.4年（受伤组和对照组）。在考克斯比例风险模型中，与可逆性急性肾损伤相关的死亡风险是显著的（风险比1.50）;然而，在随访期间对慢性肾损伤的发展进行调整可降低该风险（风险比1.18）。可逆性急性肾损伤与新发慢性肾病的显著风险相关（风险比1.91）。因此，医院相关急性肾损伤的消退事件对于既往无临床明显肾病的患者的纵向监测具有重要意义。Kidney International（2012）81，477-485; doi：10.1038/ki.2011.405; 2011年12月7日在线发表
Acute kidney injury increases mortality risk among those with established chronic kidney disease. In this study we used a propensity score-matched cohort method to retrospectively evaluate the risks of death and de novo chronic kidney disease after reversible, hospital-associated acute kidney injury among patients with normal pre-hospitalization kidney function. Of 30,207 discharged patients alive at 90 days, 1610 with reversible acute kidney injury that resolved within the 90 days were successfully matched across multiple parameters with 3652 control patients who had not experienced acute kidney injury. Median follow-up was 3.3 and 3.4 years (injured and control groups, respectively). In Cox proportional hazard models, the risk of death associated with reversible acute kidney injury was significant (hazard ratio 1.50); however, adjustment for the development of chronic kidney injury during follow-up attenuated this risk (hazard ratio 1.18). Reversible acute kidney injury was associated with a significant risk of de novo chronic kidney disease (hazard ratio 1.91). Thus, a resolved episode of hospital-associated acute kidney injury has important implications for the longitudinal surveillance of patients without preexisting, clinically evident kidney disease. Kidney International (2012) 81, 477-485; doi:10.1038/ki.2011.405; published online 7 December 2011