Clinical Analysis Of271Patients With Acute Kidney Injury

Objective: Acute kidney injury (AKI) is the concept develops on the basisof acute renal failure (ARF). ARF is a group of clinical syndrome with theglomerular filtration rate decreases rapidly, the blood urea nitrogen and serumcreatinine be detained, the water, electrolyte and acid-base balance disorders,and the systemic complications[1-3]. In2005the acute kidney injury networkworking group (AKIN) will change ARF to AKI, and the diagnostic criteriawere modified. They defined AKI as[5]: no more than3months of renalstructural or functional abnormalities, including blood, urine, or radiologicalaspects of abnormal tissue detection. Diagnostic criteria for: renal functionsuddenly (within48hours) decreased, as the increase of the absolute value ofserum creatinine≥0.3mg/dl (≥26.5μ mol/l) or increased≥50%(baselinevalues’1.5times), or urine volume <0.5ml/(kg.h) that lasted more than6hours. That modification improves the diagnostic sensitivity of AKI. Accordingto the reports in the literature[7], the hospitalized patients with AKI’soccurrence rate was up to8%, intensive care unit (ICU)’s incidence was morethan50%, of which4-5%AKI patients requiring dialysis treatment, themortality of patients with AKI which need for dialysis was up to50%-60%, sothe disease is the commonly dangerous disease in clinical all hospitals. Thisstudy aims to deepen the understanding of AKI, and further to investigate theetiology, treatment, prognosis and multiple factors’ effections on prognosis, soas to improve the level of diagnosis and treatment of AKI.Methods: This study retrospectively summarized and analyzed the clinicaldata of the hospitalized patients diagnosed AKI in our hospital from December24,2008to December23,2011, a total of271cases. All patients were groupedaccording to the criteria which the AKIN proposed in2005, the comparisons were made between groups with blood biochemical, blood routine, urineroutine, etiology, treatment, prognosis and prognostic factors etc.. UsingSPSS17.0software for data processing.Results:1.In this study there were271cases, of which,172cases (63.47%)were male and99cases (36.53%) were female.2. The etiological aspects: theprerenal factors were99cases (36.53%), the renal factors were126cases(46.49%), the postrenal factors were46cases (16.97%). In the prerenal factors,the blood volume deficiency was the majority (n=32cases,32.32%), followedby the application of mannitol (n=24cases,24.24%). In renal factors, theinfection (n=23cases,18.25%), chronic kidney disease (CKD) based on AKI(A/C)(n=23cases,18.25%) were the majority, followed by drug (n=11cases,8.73%) and multiple organ dysfunction syndrome (MODS)(11cases,8.73%).3. The therapeutic aspects: there were180cases (66.42%) with simplesymptomatic treatment,30cases (11.07%) with the operation, and61cases(22.51%) receiving dialysis treatment.4. The prognostic aspects:57cases(21.03%) were cured,102cases (37.64%) were improved, failure in22cases(8.12%),37cases (13.65%) gived up,53cases (19.56%) died.5. There were nostatistical significance between AKI’s staging and patients’ age, length ofhospital stays, but hospital departments.6. There were statistical significancebetween AKI’s staging and the serum sodium ion concentration (Na+), carbondioxide combining power levels (CO2CP).7. There were statisticalsignificance between AKI’s staging and etiology, treatment, prognosis.8. Therewere statistical significance between AKI’s etiology, treatment and prognosis.9.For the AKI patients, the respiratory system injury and MODS were the riskfactors for death.Conclusion:1.The patients in hospital with AKI were predominantly male.2. The patients in hospital with AKI were predominantly caused by renalfactors, the infection and A/C were the majority; receiving dialysis patients accounted for22.51%; the cure rate was21.03%, the mortality rate was19.56%.3. There were statistical significance between AKI’s staging andetiology, treatment, prognosis.4. There were statistical significance betweenAKI’s etiology, treatment and prognosis.5. For the AKI patients, the respiratorysystem injury and MODS were the risk factors for death.