Analysis Of Clinical Features In272Cases Associated Acute Kidney Injury

Objective：Analyze the clinical data of272cases of patients with acute kidney injurydiagnosed by our hospital retrospectively, analysis of the cause, clinical features, prognosisand risk factors, in order to improve the understanding of AKI and the prognosis of patientswith AKI.Methods：Analyze the272cases of patients with acute kidney injury diagnosed in theSecond Hosipital of Jilin University retrospectively from Sep2012to Sep2014. Clinicaldata were collected from all the enrolled patients, including gender, age, serum ureanitrogen baseline and peak, serum creatine baseline and peak, hemoglobin, serum uric acid,urine volume etc. Analyze the clinical characteristics and prognosis related risk factors ofthe272cases of of patients with acute kidney injury using statistical methods.Results:1. including There were179male cases and93female cases in the272casesof AKI patients (the male to female ratio was1.92:1). There were188911hospitalizedpatients during the study period, the morbidity of AKI was0.14%. There were66cases inyoung group(≤44years),120cases in middle-aged (45-64years),65cases in elderly group(≥65).272cases were from16clinical departments. Internal medical system accounted for79.8%and20.2%were from surgical system, Nephrology department was in the first place(63.6%), cardiac surgery department was in the second place (9.9%).2. There were126cases caused by prerenal AKI(46.3%),95cases caused by intrinsicAKI(34.9%),27cases caused by postrenal AKI(9.9%) and24cases caused by multiplefactors(8.9%). The main cause was prerenal and intrinsic combined. Etiology of each agegroup were significantly different（χ2=16.841，P=0.002）. The main cause of young groupwas intrinsic AKI, the main cause of elderly group was prerenal AKI.3. From laboratory index, with the increased AKI stage, serum cystatin C and serumkalium significantly increased(P＜0.05). AKI stage3compared with stage1, hemoglobin,hematokrit, CO2combining power decreased (P＜0.05).4. From the complication of AKI, middle age and elderly age group were prone toanemia, hypoalbuminemia and oliguria compared with young group(P＜0.05). 5. The patients with hypertension were the most(59.6%). Middle age group comparedwith young group, cardiovascular disease, cerebrovascular disease and tumor increased (P＜0.05). Except hypertension, all the other complications（diabetes, cardiovascular disease,cerebrovascular disease, tumor）were higher than young group(P＜0.05).6. In272patients,45cases died (16.5%),34cases of the dead were prerenalAKI(12.5%). Acording to group prerenal, intrinsic, posrrenal+multiple factors，mortalityhad a significant differences among each group（χ2=19.546， P＜0.01）. The mortality ofprerenal AKI was higher than the other groups, the difference is statistically significant.Further analysis the cases of prerenal AKI patients, there were17cases of decreasedcardiac output,10cases of sepsis,7cases of lack of effective circulating blood volume,patients with decreased cardiac output and sepsis had worse prognosis than the patientswith lack of effective circulating blood volume (P <0.01).7. Single factor Logistic analysis showed that the aged, infection, hyperuricaemia,serum albumin, hyperkalemia, organ failure numbers, dialysis were the mortality relatedrisk factors, while serum albumin was the protective factor. Further multi-factor Logisticregression analysis showed that hyperuricaemia, and organ failure number were theindependent risk factor of mortality in patients with AKI.Conclusion: The etiology consititution of AKI was different among all age groups, youthwas given priority to with intrinsic AKI, elderly group was given priority to pretrenal AKI.Middle age and elderly age group were prone to anemia, hypoalbuminemia and oliguriacompared with young group. The complications increased with age. The mortality ofprerenal AKI was the highest among the three groups. Further analysis the cases of prerenalAKI patients, patients with decreased cardiac output and sepsis had worse prognosis thanthe patients with lack of effective circulating blood volume. Multi-factor Logisticregression analysis showed that hyperuricaemia, and organ failure number were theindependent risk factor of mortality in patients with AKI.