The Clinical Characteristics And Prognosis Of 206 Cases With Acute Kidney Injury

Background and Objective:Acute kidney injury is a clinical syndrome characterized by a rapid loss of renal excretion function,which is associated with an increased in mortality in hospitalized patients.In recent years,the incidence and mortality of AKI remain high,despite the continuous improvement of medical care.AKI not only increases the patient's hospitalization time and cost,but also occupies a large amount of social resources,which adds an economic burden to patients and society.Therefore,it is urgent to understand the clinical characteristics of patients with AKI,so as to provide help for the early clinical intervention for AKI.The purpose of this study is to find out the factors associated with renal prognosis by understanding the general clinical data of patients with AKI and to provide the basis for the clinical treatment of AKI.Methods:1.The clinical data of patients with AKI from August 2012 to July 2016 in Bethune International Peace Hospital were collected,and the demographic data,underlying diseases,serological markers,AKI stage,etiological distribution and clinical treatment of patients with AKI were analyzed,and factors related to renal prognosis were found.2.The patients were divided into the elderly group(?60 years old)and the non-elderly group(<60 years old)by age.The average days of hospitalization,underlying diseases,AKI stage,etiology distribution and renal prognosis were compared between those two groups of patients with AKI.3.According to the renal function at discharge,the patients were divided into the renal function recovery group and the renal function non-recovery group.The underlying diseases,serological markers,clinical treatment and accompanying symptoms were compared between those two groups of patients with AKI.Logistic regression analysis was used to analyze the related factors of renal prognosis in patients with AKI at discharge.Results:1.A total of 206 patients with AKI were enrolled in this study,with a male to female ratio of 2.03:1 and an average age of 55.53±21.19 years old.The serum creatinine was 359.84±329.87umol/L at diagnosis of AKI,and was 165.02±173.14umol/L at discharge.The proportion of patients with AKI stage ?,stage ?and stage ?were 34.0%,15.0% and 51.0% respectively.Insufficient effective blood volume and infection were the most common causes of AKI.2.There were 97 cases(47.1%)in the elderly group and 109 cases(52.9%)in the non-elderly group.The elderly patients with more underlying diseases,whose kidney recovery ratio was low at discharge,were the high-risk group of AKI.3.There were 128 cases(62.1%)of renal function recovery group and 78 cases(37.9%)of renal function non-recovery group.Multivariate Logistic regression analysis showed that Hemoglobin(OR 0.967,P < 0.05)was protective factor for the prognosis of patients with AKI.Age(OR 1.024,P<0.05)and requiring renal replacement therapy(OR 5.227,P < 0.05)were independent risk factors for the prognosis of patients with AKI.Conclusion:1.AKI was a common clinical syndrome,and the prognosis was associated with the severity of renal injury.2.Insufficient effective blood volume and infection were the most common causes of AKI.3.The elderly patients with more underlying diseases were the high-risk group of AKI.4.Hemoglobin was independent protective factors for the prognosis of AKI patients.Age and requiring RRT were independent risk factors for the prognosis of AKI patients.