| Objective:Investigate the incidence,clinical features,prognosis and risk factors of cardiorenal syndrome in the Renal Intensive Care Unit(RICU)of Jinling Hospital.Methodology:Retrospectively analyzed the clinical data of patients who were diagnosed with cardiorenal syndrome and admitted to the ICU of Jinling Hospital from Oct.2013 to Nov.2016.According to the international classification standard,the patients were divided into 5 types.According to whether the patients died or entered the regular dialysis during the follow-up period,they were divided into the stable prognosis group and the poor prognosis group.Baseline clinical features and laboratory parameters were compared among various types of CRS,between patients with stable and poor prognosis,Logistic regression analysis was used to analyze risk factors for CRS outcomes.Results:(1)A total of 363 patients with cardiorenal syndrome were admitted in 3 years,accounting for 21%of the hospitalized patients(1731 patients)in the same period.There were 182 CRS patients who met the inclusion and exclusion standard of this study,of which 11(6%)were type 1,9(5%)were type 2,19(11%)were type 3 and 26(14%)were type 4,and 117 were type 5(64%).(2)Of the 182 CRS patients,87 were males and 95 were females.The incidence of males and females was not statistically significant.The median age of 182 patients with CRS was 48(33,63)years,The patients aged<20 years,21-40 years,41-60 years,61-80 years,and>81 years were 6 cases,63 cases,59 cases,50 cases,and 4 cases respectively.(3)Among the secondary systemic diseases of type 5,diabetes(43 cases)?systemic lupus erythematosus(40 cases)and sepsis(10 cases)were among the top two.While hypertension(9 cases)and amyloidosis(8 cases)ranked 4th and 5th respectively?and the remaining causes were:multiple myeloma,chronic liver disease,thrombotic microangiopathy,systemic sclerosis,and malaria.(4)In the comparison of CRS1-5 clinical laboratory indexes,age,history of hypertension,co-infection,history of cardiovascular disease,history of diabetes,Left ventricular diastolic function,heart rate,glomerular filtration rate,interleukin-6,blood triglycerides,serum creatinine was statistically significant between each subtype(P<0.05),and gender,smoking history,history of cerebrovascular disease,history of hypothyroidism,and left ventricular ejection fraction,hospitalization days,systolic blood pressure,diastolic blood pressure,hemoglobin content,serum albumin,C-reactive protein,NT-ProBNP,blood cholesterol,Urea nitrogen,uric acid were not statistically different between the CRS1-5 types.(5)Overall prognosis of CRS patients was poor.Of 182 patients,there were 119(65.4%)who had a poor prognosis,of which 96(52.75%)were regularly dialyzed and 23(12.64%)died.Except CRS type 1,there were more than 60%of type 2-5 patients who had poor prognosis.The patients with diabetes history,systemic lupus erythematosus,and sepsis had poor prognosis at the time of onset.Patients with poor prognosis were followed by 48 patients(71.6%),22 patients(55.0%),and 9 patients(90.0%).(6)Logisitc regression results:Diabetes history and elevated serum creatinine are the independent prognostic factor of patients with poor prognosis.The onset of high hemoglobin levels is a protective factor for stable patient outcomes.Conclusion:Cardiorenal syndrome is a common clinical syndrome in the RICU,of which CRS type 5 is the most common.Diabetes and systemic lupus erythematosus are the leading causes of type 5.The overall prognosis of patients with CRS is poor.The patients with diabetes history and elevated serum creatinine have poor prognosis.Patients with CRS have poor prognosis and need to be given enough attention by clinicians to achieve early diagnosis,early treatment and early rehabilitation. |
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