Pattern of acute renal failure in a tertiary hospital in the United Arab emirates
Pattern of acute renal failure in a tertiary hospital in the United Arab emirates
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DOI：
10.1016/j.transproceed.2004.07.015
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发表时间：
2004-07-01
影响因子：
0.9
通讯作者：
Dastoor, H
中科院分区：
文献类型：
--
作者：
Bernieh, B;Al Hakim, M;Dastoor, H
急性肾衰竭（ARF）是肾脏病学中的一个具有挑战性的问题。为了评估我们三级医院 ARF 的模式、治疗和结果，我们分析了 2002 年 1 月至 2003 年 6 月期间住院的所有 81 名患有或正在发生 ARF 的患者的数据。这 45 名男性和 36 名女性平均年龄为 56.2 +/- 21（范围 13 至 91）岁，在病房（n = 48；59%）和/或在 ICU（n = 33; 41%) 10% 因 ARF 直接入院肾病科，90% 在医院发生 ARF。 30% 由肿瘤科转诊，15% 由普通医学转诊。脓毒症是 36 名患者 (44%) 发生 ARF 的原因，其次是 11 名患者 (14%) 患者的药物肾毒性，以及 9 名患者 (11%) 的梗阻性尿路病。 28 名（35%）人患有高血压； 27 人（33%）患有糖尿病；慢性肾功能衰竭，19（23%）；缺血性心脏病 19 例（23%）；和肝脏疾病12（15%）。最常见的诱发因素是 42 例 (52%) 中的低血压、32 例 (40%) 中的脱水以及 20 例 (25%) 中的药物肾毒性。 60 名患者 (74%) 接受保守治疗，21 名患者 (26%) 需要肾脏替代治疗。住院时间为 29.5 +/- 38.4（范围 2 至 279）天。病房管理的患者存活率为 71%，而 ICU 患者的存活率为 33% (P < .00001)。病房患者的肾存活率为 83%，而 ICU 患者的肾存活率为 48% (P < .001)。本研究表明，大多数ARF是在医院内发生的，其中肿瘤科患者所占比例最大。脓毒症是 ARF 的主要原因，而低血压是主要诱发因素。在 ICU 接受治疗的患者的患者和肾脏生存预后均较差。
Acute renal failure (ARF) is a challenging problem in nephrology. To evaluate the pattern, management and outcome of ARF in our tertiary hospital, we analyzed the data of all 81 patients admitted with or developing ARF in hospital between January 2002 and June 2003. The 45 men and 36 women of mean age 56.2 +/- 21 (range 13 to 91) years were managed either on the ward (n = 48; 59%) and or in the ICU (n = 33; 41%) 10% were direct admissions to the nephrology service with ARF, and 90% developed ARF in hospital. Thirty percent were referred by oncology services and 15% by general medicine. Sepsis was the cause of ARF in 36 (44%) patients, followed by drug nephrotoxicity in 11 (14%), and obstructive uropathy in 9 (11%). Comorbid conditions were hypertension in 28 (35%); diabetes in 27 (33%); chronic renal failure, 19 (23%); ischemic heart disease 19 (23%); and liver disease 12 (15%). The most common predisposing factor was hypotension in 42 (52%), dehydration in 32 (40%), and drug nephrotoxicity in 20 (25%). Sixty patients (74%) were managed conservatively, and 21 (26%) required renal replacement therapy. The length of hospital stay was 29.5 +/- 38.4 (range 2 to 279) days. Patient survival for those managed on the ward was 71% compared to 33% for ICU patients (P < .00001). Renal survival was 83% for ward patients, compared to 48% for those in the ICU (P < .001). This study showed that majority of ARF developed in-hospital with oncology patients constituting the greatest proportion. Sepsis was the leading cause of ARF and hypotension, the main predisposing factor. Patients treated in the ICU showed a worse prognosis for both patient and renal survival.