Epidemiology and Clinical Correlates of AKI in Chinese Hospitalized Adults
Epidemiology and Clinical Correlates of AKI in Chinese Hospitalized Adults
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中国住院成人 AKI 的流行病学和临床相关性
DOI：
10.2215/cjn.02140215
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发表时间：
2015-09-01
影响因子：
9.8
通讯作者：
Hou, Fan Fan
中科院分区：
文献类型：
--
作者：
Xu, Xin;Nie, Sheng;Hou, Fan Fan
背景和目的亚洲国家尤其缺乏阿基的全面流行病学数据。设计、设置、参与者和测量这是一项多中心回顾性队列研究，2013年在中国9家地区中心医院的659，945名住院成人中进行了广泛的临床设置。阿基根据肾脏疾病改善全球结局标准进行定义和分期。使用一种新的两步法估计队列中阿基的发生率，并调整血清肌酐检测频率和其他潜在混杂因素。检查了医院获得性（HA）和社区获得性（CA）阿基的风险因素特征。结果CA-AKI和HA-AKI的发生率分别为2.5%和9.1%，总发生率为11.6%。尽管CA-AKI和HA-AKI的风险特征不同，但既存CKD是两者的主要风险因素，占CA-AKI风险的20%和HA-AKI风险的12%。约40%的阿基病例可能与药物有关，16%可能是由中药或中药引起的。阿基的住院死亡率为8.8%。在较严重阿基患者中，院内死亡风险较高。在任何阶段的阿基患者中，既存CKD和需要入住重症监护室与较高的死亡风险相关。一过性阿基不会改变院内死亡的风险。阿基与较长的住院时间和较高的每日费用，即使调整混杂因素后，结论阿基是常见的住院成人在中国，并与显着较高的住院死亡率和资源利用。
Background and objectives Comprehensive epidemiologic data on AKI are particularly lacking in Asian countries. This study sought to assess the epidemiology and clinical correlates of AKI among hospitalized adults in China.Design, setting, participants, & measurements This was a multicenter retrospective cohort study of 659,945 hospitalized adults from a wide range of clinical settings in nine regional central hospitals across China in 2013. AKI was defined and staged according to Kidney Disease Improving Global Outcomes criteria. The incidence of AKI in the cohort was estimated using a novel two-step approach with adjustment for the frequency of serum creatinine tests and other potential confounders. Risk factor profiles for hospital-acquired (HA) and community-acquired (CA) AKI were examined. The in-hospital outcomes of AKI, including mortality, renal recovery, length of stay, and daily cost, were assessed.Results The incidence of CA-AKI and HA-AKI was 2.5% and 9.1%, respectively, giving rise to an overall incidence of 11.6%. Although the risk profiles for CA-AKI and HA-AKI differed, preexisting CKD was a major risk factor for both, contributing to 20% of risk in CA-AKI and 12% of risk in HA-AKI. About 40% of AKI cases were possibly drug-related and 16% may have been induced by Chinese traditional medicines or remedies. The in-hospital mortality of AKI was 8.8%. The risk of in-hospital death was higher among patients with more severe AKI. Preexisting CKD and need for intensive care unit admission were associated with higher death risk in patients at any stage of AKI. Transiency of AKI did not modify the risk of in-hospital death. AKI was associated with longer length of stay and higher daily costs, even after adjustment for confounders.Conclusion AKI is common in hospitalized adults in China and is associated with significantly higher in-hospital mortality and resource utilization.