Long-term outcomes of acute kidney injury
Long-term outcomes of acute kidney injury
复制标题
DOI：
10.1053/j.ackd.2008.04.009
复制
发表时间：
2008-07-01
影响因子：
2.9
通讯作者：
Dennen, Paula
中科院分区：
文献类型：
--
作者：
Goldberg, Ryan;Dennen, Paula
急性肾损伤（阿基）在重症监护室中很常见，并与显著的发病率和死亡率相关。根据步枪标准，重症监护室（ICU）中高达67%的患者发生阿基，其中约4%的重症患者需要肾脏替代治疗（RRT）。众所周知，需要RRT的阿基患者亚组的院内死亡率超过50%。然而，需要RRT的阿基幸存者的长期结局仍然描述不多。与未发生阿基的重症患者相比，AKI存活患者的长期死亡率更高。肾和肾外的长期发病率是阿基的常见并发症，但未得到充分重视。在长期随访（1-10年）的阿基幸存者中，约12.5%依赖透析（范围为1%-64%，取决于患者人群），19%-31%患有慢性肾脏疾病。根据美国肾脏数据系统，作为终末期肾病原因的“急性肾小管坏死无恢复”从1994 - 1998年的1.2%增加到1999 - 2003年的1.7%。随着人口老龄化、合并症的增加和重症监护室能力的扩大，发病率可能会继续上升。阿基是慢性肾脏病（CKD）的一种未被充分认识的原因，应密切随访存活患者的新发CKD和/或基础CKD进展（C）2008由国家肾脏基金会，Inc. All rights reserved.
Acute kidney injury (AKI) is common in the intensive care unit and is associated with significant morbidity and mortality. Based on the RIFLE criteria, AKI occurs in up to 67% of patients in the intensive care unit (ICU), with approximately 4% of critically ill patients requiring renal replacement therapy (RRT). It is well known that this subset of AKI patients who require RRT have an in-hospital mortality rate exceeding 50%. However, long-term outcomes of survivors of AKI requiring RRT remain poorly described. Long-term mortality is greater in those patients who survived AKI when compared with critically ill patients without AKI. Long-term morbidity, renal and extrarenal, is a frequent and underappreciated complication of AKI. Among survivors of AKI at long-term follow-up (1-10 years), approximately 12.5% are dialysis dependent (wide range of 1%-64%, depending on the patient population) and 19% to 31% have chronic kidney disease. According to the United States Renal Data System, "acute tubular necrosis without recovery" as a cause of end-stage kidney disease increased from 1.2% in 1994 to 1998 to 1.7% in 1999 to 2003. The incidence will likely continue to rise with the aging population, increase in comorbidities, and expansion of intensive care unit capabilities. AKI is an underrecognized cause of chronic kidney disease (CKD) and patients who survive should be followed closely for new CKD and/or progression of underlying CKD (C) 2008 by the National Kidney Foundation, Inc. All rights reserved.