Prevalence Survey And Analysis Of Acute Kidney Injuryin First Affiliated Hospital Of Medical College,Shihezi University,Xinjiang

Objective:The objectives of this study were to investigate the pathogenesis,etiology and clinical outcome of acute kidney injury(AKI)in hospitalized patients,and to provide reliable theoretical basis for early detection,prevention and treatment of AKI.Methods:Between Jan.to Dec.2015 all the hospitalized patients in First Affiliated Hospital of Medical College were screened by Laboratory data retrieval system.Our study cohort was comprised of all the patients with AKI defined by latest clinical guidelines of KDIGO(Kidney Disease:Improving Global Outcomes KDIGO)for definition of the renal creatinine.We analysed the demographic and clinical characteristics,AKI stage,etiology,distribution of the department,accompanying the underlying disease and clinical outcome of the patients.Logistic regression analysis was used to investigate the risk factors of mortality and renal prognosis.Results:Of all the 58444 hospitalized patients,609 patients with AKl,the patient composition ratio was1.04%.The ratio of male to female was(2.07:1),age was(66.33?16.03)years old.In the age distribution of patients with AKI,the proportion of patients aged 60-79 years was 50.74%.In the distribution of patients with AKI,ICU patients accounted for the highest proportion(17.9%),the proportion of surgical inpatients with AKI higher than the medical patients.The patients with susceptibility factors,diabetes(?~2=11.075,P=0.026),chronic heart failure(?~2=54.707,P<0.001),chronic kidney injury(?~2=13.2,P=0.010)were different in age distribution.The reasons for hospitalized patients with AKI were prerenal?intrarenal?postrenal accounted for 70.6%(n=430)?21.5%(n=131)?7.9%(n=48),respectively.By KDIGO criteria43.2%(n=263)had Stage 1,40.9%(n=249)had Stage 2 and 15.9%(n=97)had Stage 3.Patients with different stages,the outcome of renal function is also different.The higher the stage of AKI patients,the more difficult the patient to restore renal function to baseline.In the final observation,complete renal unrecovery rate was 29.9%,partial renal recovery rate was 40.9%,complete renal recovery rate was 18.7%.177 patients died in the final observation,the proportion of deaths accounted for 29.1%.Multivariate logistic regression analysis showed that the risk factors for mortality were age?75years old(OR=1.966,95%CI 1.293~2.991,P=0.002),coma(OR=2.608,95%CI1.620~4.199,P<0.001),low blood pressure(OR=2.467,95%CI 1.387~4.387,P=0.002).Organ failure except kidney(OR=2.509,95%CI 1.690~3.724,P<0.001),AKI stage(OR=0.741,95%CI1.0.577~0.951,P=0.019),were the risk factors for renal unrecovery.Conclusions:In hospitalized patients,older patients with high incidence of AKI,prerenal was the main reason for AKI.The higher the stage of AKI patients,the more difficult the patient to restore renal function to baseline renal function.Age?75 years,coma,hypotension were the risk factors of death in hospitalized patients with AKI.AKI stage,organ failure except kidney were the risk factors for renal function unrecovery in hospitalized patients with AKI.