| ObjectsAccording to the KDIGO standard, The incidence, mortality, prognosis and risk factors of AKI were retrospectively analyzed in the Fourth People's Hospital of Ji'nan city from January 2012 to June 2016.MethodsRetrospective analysis of 1200 patients that come from ICU of fourth people's Hospital of Ji'nan city from June 2016 to January 2012.According to KDIGO diagnostic criteria and staging standards, The selected 687 patients were divided into 4 groups:NAKI431 patients, AKI ? 108 cases of patients,76 cases of AKI ? period,72 cases of patients with AKI. The basic situation of the 4 groups of patients, APACHEII score, the number of MODS, the time to stay in intensive care unit. To analyze the relationship between mortality rate and stage CRRT, and to study the risk factors that affect the occurrence of AKI.ResultsAnalysis of basic data of patients, older than 60 years, the application of ventilator assisted breathing including invasive and non-invasive ventilator, acute left heart failure, various types of shock, respiratory failure are the risk factors that occurred to acute renal injury, with higher incidence of AKI Patients in group AKI had higher blood lactic acid level, APACHEII score, diuretic drug application, serum potassium level, lower pH level, blood protein level and GCS score. The mortality rate of patients increased with the increase of AKI stage. The survival of AKI patients with ICU was significantly longer than that of the patients who did not occur AKI, and with the AKI staging of patients with increased hospital stay was also significantly increased, the difference was statistically significant (P<0.05).With the increase of AKI stage, the mortality of the patients increased significantly. The CRRT treatment will significantly improve the prognosis of patients, reduce the time to stay ICU, especially the emergence of water electrolyte disorder, acid-base imbalance, the effect is more obvious, but also significantly shorten the time to live in patients with ICU. By Spearman rank correlation analysis, ICU mortality increased with the aggravation of AKI stage (P<0.05, r=0.418), and the CRRT treatment was negatively correlated (P<0.05, r=0.583).However, there was no significant difference in mortality between early and late CRRT treatment. Analysis of risk factors of AKI patients and related factors of logistic:a comparative analysis of age, BMI, basic diseases (coronary heart disease, hypertension, diabetes, chronic obstructive pulmonary disease, chronic renal failure, malignant tumor, diseases of the immune system, blood system diseases), diagnosis of ICU stay mainly. Age, underlying disease, septic shock, cardiopulmonary resuscitation, and ventilator assisted breathing were the risk factors for AKI. Analysis of the incidence of AKI group and blood gas analysis, blood biochemical examination, vasoactive drugs and diuretic drug treatment, the application of contrast agent. Acidosis, serum potassium level, and the use of contrast agents were independent risk factors for AKI. Furosemide diuretics in improving pulmonary edema, but also decrease the level of serum creatinine in AKII phase, reducing the number of CRRT treatment, to reduce the number of days of ICU patients with AKI. And there was no significant difference in the patients with stage AKIII and AKIIII. Except for the case of hemorrhagic shock, prognosis and mortality of the disease and application of liquid crystal Human Albumin had no statistical significance, but the hydroxyethyl starch may increase the incidence of AKI and mortality risk.ConclusionThe KDIGO standard is of great significance in clinical application. It can help the doctors to diagnose and treat the AKI as soon as possible, so as to improve the treatment rate of AKI patients. CRRT as soon as possible treatment, although it can not improve the survival rate of the patients, but can significantly improve the prognosis and reduce the days of ICU stay, reduce the medical cost, reduce the patients' economic pressure. |
PDF Full Text Request