Clinical Characteristics And Prognosis Of 204 Cases With Acute Kidney Injury

Objective: To Summarize the etiology,clinical characteristics of AKI and judge the related influencing factors of AKI patients on prognosis.Method:This retrospective study included 204 AKI cases in nephrology department of The First affiliated hospital of chongqing medical university From January 2014 to December 2016.The clinical data of the 204 cases were reviewed.Results:1.Among the 204 patients with AKI,129 cases were male,75 cases were female,male:female = 1.72:1.The mean age was 50.68±20.00 years old.The Proportion of all age groups:?40 years old group consisted 65 cases(31.9%),41-60 years old group consisted 65 cases(32.3%),?61 years old group congsisted 73 cases(35.8%).2.Etiologically,the patterns of AKI included pre-renal(33,16.2%),renal parenchyma(143,70.1%),and post-renal(28,13.7%).Pre-renal AKI were performed in 33 patients,among which the insufficient blood volume caused by acute gastroenteritis accounted for the biggest proportion.The majority cause of Renal parenchyma AKI were Acute interstitial nephritis(53,37.1%),Acute tubular necrosis(42,29.4%),glomerular vascular lesions(38,26.6%).Among these143 cases,63 cases were caused by drugs.Prostate disease is the most common in pre-renal AKI,tumor metastasis and invasion,Urinary calculi follwed.3.To analysised the clinical features according to the age groups: Hemoglobin,cholester of the youth group is higher than other age groups,Cholesterol of the youth group is higher than the elderly group.Compared with youth group,elder group also has a high incidence in basic disease,especially in cerebrovascular disease,high blood pressure,diabete.The incidency of coronary heart disease in elder group is significantly higher than the rest of the two groups.(P<0.05).Acidosis(P = 0.000),The data of Serum creatinine peak is higher and the incidence of MODS(P = 0.002),hyperkalemia(P= 0.003))are more frequent in old group than youth group too.4.Univariate factor analysis showed that sex,etiology,age,AKI stage,hemoglobin,red blood cells deposited,potassium,serum albumin,serum creatinine peak,urine protein 1~3+,edema,hypertension,oliguria,metabolic acidosis,MODS,renal replacement therapy was associated with AKI prognosis.Multiple variable Logistic regression analysis results showed that the independent risk factors for AKI prognosis were metabolic acidosis,MODS,higher serum creatinine peak;Hemoglobin was the protective factor.Conclusion:1.Renal parenchyma AKI is the major components in nephrology department.Attention must be paid to reduce the indicience of nephrotoxity drug related AKI.2.Metabolic acidosis,MODS,higher serum creatinine peak were the independent risk factors for AKI prognosis,Hemoglobin was the protective factor.3.Attention should be paid to guard against AKI before it happen,when the patiens progress to AKI stage,attention should be paid to prevent the happening of the complications,especially the MODS.