南方医科大学学报2016，Vol.36Issue(6)：744-750,7.DOI:10.3969/j.issn.1673-4254.2016.06.02
中国危重症住院患者急性肾损伤的流行病学分析
Epidemiology of acute kidney injury in Chinese critical patients
摘要
Abstract
Objective To investigate the epidemiological profile of acute kidney injury (AKI) in the Chinese critical patients. Methods The hospitalization data and serum creatinine data of critically ill adult patients were collected from 9 regional central hospitals across China in 2013. Kidney Disease Improving Global Outcomes (KDIGO 2012) criteria was used to define and stage AKI. The demographic characteristics of the patients, comorbidities, stage of AKI, in-hospital outcomes and risk factors were retrospectively analyzed. Results Of the total of 14 305 critically ill patients included in the study, 4298 (30.04%) were identified to have AKI, including 2240 (52.1%) in stage 1, 845 (19.7%) in stage 2, and 1213 (28.2%) in stage 3. The in-hospital mortality rate was 16.7%(716/4298) and the odds ratio for death was 7.59 (95%CI 6.54-8.79, P<0.001). The length of hospital stay, daily cost, and mortality rate were associated with the stage of AKI. Multivariate analysis identified chronic kidney disease (OR=5.45, 95%CI: 4.71-6.32, P<0.001), extra-renal organ failure (OR=12.57, 95%CI: 11.24-14.07, P<0.001), shock (OR=2.44, 95%CI:2.01-2.96, P<0.001) and cardiac surgery (OR=5.96, 95%CI:5.16-6.87, P<0.001) as the independent risk factors for AKI. Only 5.4%of the AKI patients whose serum creatinine change met the KDIGO criteria during hospitalization received the diagnosis of AKI upon discharge. Conclusion AKI is common in critically ill patients and associated with high mortality rates and poor outcomes. The stage of AKI is related with the in-hospital outcomes of the patients. Chronic kidney disease, extra-renal organ failure, shock and cardiac surgery are the major risk factors for AKI in these patients. Missed diagnosis occurs in most of the AKI cases, which urges more awareness of the condition in the critically ill patients during hospitalization.关键词
急性肾损伤/危重症/发生率/危险因素Key words
acute kidney injury/critical illness/incidence/risk factors引用本文复制引用
雷莹,聂晟,孙丹华,宾伟,徐欣..中国危重症住院患者急性肾损伤的流行病学分析[J].南方医科大学学报,2016,36(6):744-750,7.基金项目
国家自然科学基金重点项目（81430016）；国家科技支撑计划（2015BAI2B07） Supported by National Natural Science Foundation of China (81430016) （81430016）
