Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis.
Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis.
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DOI：
10.1038/ki.2011.379
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发表时间：
2012-03
影响因子：
19.6
通讯作者：
中科院分区：
文献类型：
--
作者：
急性肾脏损伤可能会增加慢性肾脏疾病和终末期肾脏疾病的风险。为了总结文献并提供更令人信服的证据，我们进行了一项系统的回顾，比较了有和没有AKI的患者发生CKD、ESRD和死亡的风险。从电子数据库、网络搜索引擎和书目中选择了13项队列研究，评估AKI患者的长期肾脏结果和非肾脏结果。CKD和ESRD的混合发病率分别为25.8/100人年和8.6/100人年。与非AKI患者相比，AKI患者发生CKD(合并调整危险比8.8，95%CI 3.1~25.5)、ESRD(合并调整HR 3.1，95%CI 1.9~5.0)和死亡率(合并调整HR 2.0，95%CI 1.3~3.1)的风险较高。AKI与CKD或ESRD的关系根据AKI的严重程度进行分级，其影响大小受到基线肾小球滤过率下降的影响。数据有限，但AKI也与心血管疾病和充血性心力衰竭的风险独立相关，但与中风住院或全因住院无关。Meta回归分析未发现任何与慢性肾脏病或终末期肾病风险相关的研究水平因素。我们的综述发现AKI是慢性肾脏病、终末期肾病、死亡和其他重要的非肾脏结局的独立危险因素。
Acute kidney injury may increase the risk for chronic kidney disease and end-stage renal disease. In an attempt to summarize the literature and provide more compelling evidence, we conducted a systematic review comparing the risk of CKD, ESRD and death in patients with and without AKI. From electronic databases, web search engines, and bibliographies, 13 cohort studies were selected, evaluating long-term renal outcomes and non-renal outcomes in patients with AKI. The pooled incidence of CKD and ESRD were 25.8/100 person-years and 8.6 per 100 person-years, respectively. Patients with AKI had higher risks of developing CKD (pooled adjusted hazard ratio 8.8, 95% CI 3.1-25.5), ESRD (pooled adjusted HR 3.1, 95% CI 1.9-5.0) and mortality (pooled adjusted HR 2.0, 95% CI 1.3-3.1) than patients without AKI. The relationship between AKI and CKD or ESRD was graded depending on the severity of AKI and the effect size was dampened by decreased baseline glomerular filtration rate. Data were limited, but AKI was also independently associated with the risk for cardiovascular disease and congestive heart failure, but not with hospitalization for stroke or all-cause hospitalizations. Meta-regression did not identify any study level factors that were associated with the risk for CKD or ESRD. Our review identifies AKI as an independent risk factor for CKD, ESRD, and death and other important non-renal outcomes.
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DOI：
10.1097/01.asn.0000064946.94590.46
发表时间：
2003-06-01
影响因子：
13.6
作者：
Kelly, KJ
通讯作者：
Kelly, KJ
影响因子：
13.6
作者：
Xue, Jay L.;Daniels, Frank;Collins, Allan J.
通讯作者：
Collins, Allan J.
影响因子：
13.6
作者：
Ishani, Areef;Xue, Jay L.;Collins, Allan J.
通讯作者：
Collins, Allan J.
影响因子：
8.8
作者：
Swaminathan, Madhav;Shaw, Andrew D.;Stafford-Smith, Mark
通讯作者：
Stafford-Smith, Mark
DOI：
10.1186/cc5949
发表时间：
2007
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bagshaw SM;George C;Bellomo R;ANZICS Database Management Committee
通讯作者：
ANZICS Database Management Committee