Clinical Analysis And Prognosis Of35Cases Of Acute Kidney Injury

(Background and Objective] Acute kidney injury (AKI) is one of the common clinical emergency and severe cases, which cause the rapid decline of kidney function,progressive increase of urea nitrogen and serum creatinine and decrease of eurine. In2005, acute kidney injury network (AKIN) formulated the new commen view of acute kidney injury in Amsterdam, Holland. The definition of AKI given by AKIN is:the abnormal performances of renal function or structure, which include the abnormal occurrences of blood, urine and tissue tests or the abnormal performance of renal injury maker. According to foreign literature, ARF incidence accounted for2%of hospitalized patients. The hospitalized patients of nephrology department were13.3%. The mortality rate was18.1%-69.6%.Acute kidney injury is a complicated kidney malfunction that can happen in different kinds of clinical cases for various reasons. At present, the causes of AKI are divided into three aspects:renal, postrenal and prerenal. Because AKI is characterized by abrupt onset with varied dangerous conditions and is different to control, the delay in treatment may lead to a poor prognosis, and even threaten the lives of patients. Therefore, a comprehensive understanding of the risk factors, epidemiological status and the influence of the prognosis of the AKI, the improving awareness of the disease of the majority of clinicians, updating their knowledge to grasp early diagnosis, early treatment of the basic techniques for reducing the dangers of the disease are extremely significant. The main objects of this study are the hospitalized AKI patients in our department. This paper collects the patients’ medical history data, clinical data, test data and prognosis data, analyzes the composition of patients’ age and gender, pathogeny, clinical characteristics and prognostic factors, in order to increase the knowledge of AKI, improve the treatment of AKI and provide new ideas to prevent and cure AKI.[Methods]Collected the clinical data of35AKI patients cases which were treated in our hospital during May,2009and October,2011, analyzed the causes, distribution characteristics, and risk factors of AKI, adopted the regression analysis to assess the risk factors of AKI prognosis.[Results](1)35patients were male and15females, mean age46.32±15.7years old, the young group (≤40years)13cases, middle-aged group (41to60years)13cases, older group (≥61years old The)9cases;25cases (20cases of Nephrology, medical patients), seven cases of surgical, ICU2case, one cases of Interventional Radiology; average hospital stay was15.6±12.8days.(2) in the distribution of the cause of prerenal of AKI7cases accounted for20%, mainly due to fluid loss, infection, heart dysfunction; renal25cases of AKI, accounting for71%; which glomerular and renal vascular10cases of disease, accounting for40%of renal factors,15cases of interstitial disease, accounting for60%of renal factors, the main cause of nephrotic syndrome, drugs, infections and other factors; renal nature of AKI after, accounting for8.6%, the main cause stones, cancer and other obstructive cause. Iatrogenic AKI eight cases,22.9%of the total number of cases, the main reason for the surgery, drugs, inappropriate use. Drug-induced AKI eight cases, accounting for22.9%, which the iatrogenic AKI6cases, two cases of patients with drug abuse. Acute renal failure in chronic kidney disease on the basis of six cases,17.1%of the total number of cases.5cases of renal biopsy.(3)35cases of AKI Bank of renal replacement treatment of13cases (37.1%), hemodialysis,29cases (82.9%) were cured in six cases, improved in20cases,3cases died, and continuous renal replacement therapy in6cases (16.22%), which improved in one cases,5cases died. Discharged cured15cases (42.9%), improved in14cases (40%),6patients died (17.1%).(4) Univariate analysis showed that gender, age, previous history of high blood pressure, urine output, hematuria MODS may be the prognosis of AKI impact Logistic regression analysis showed that age, previous history of hypertension, hyperkalemia, urine the amount of MODS factors affecting mortality.[Conclusions]1. AKI is still an important clinical complication which has higher occurrence rate.2. The data of this paper shows that the main cause of AKI is MODS and the iatrogenic aspect is one of the important causes.3. The risk factors are age (≥61years old), the past history of anti hypertension, hyperkalemia and multiple organ failure.