印度重症监护病房急性肾损伤患者的临床概况和预后:一项回顾性研究

V. Pillai, C. Verghese, C. Pais, V. Rai, M. Chakrapani
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摘要

背景:在发展中国家,急性肾损伤(AKI)的流行病学和结局数据缺乏。目前的单点研究旨在通过试图确定表现症状、病因、治疗方法和疾病预后,确定印度Mangalore一家三级医疗机构重症监护病房收治的AKI患者的临床概况。方法:2001年10月至2003年10月,在芒格洛尔文洛克区医院、芒格洛尔阿塔瓦尔KMC医院和芒格洛尔Jyothi圈KMC医院对70例血清肌酐水平大于1.4 mg/dl、血尿素大于53 mg/dl的AKI患者进行回顾性研究。结果:入组患者中,40 ~ 60岁年龄组占45.7%,男性49例,性别差异无统计学意义(p=0.412)。最常见的症状是排尿减少,在47.1%的患者中出现,AKI最常见的病因是败血症,这也与最高的死亡率(17.1%)相关。接受保守治疗的患者(n=52)的死亡率为42.8%,而接受血液透析的患者(n=18)的死亡率为4.2%。总生存率为52.9%。结论:本研究的流行病学数据与印度先前的研究一致,血液透析似乎比保守治疗有更好的疾病结局。
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Clinical Profile and Outcomes of Acute Kidney Injury Patients in an Intensive Care Unit in India: A Retrospective Study
Background: In developing countries, there is a scarcity of epidemiology and outcome data on acute kidney injury (AKI). The current single-site study aims to define the clinical profile of AKI in patients admitted to intensive care units at a tertiary care institution in Mangalore, India, by attempting to identify the presenting symptoms, etiologies, treatment methods, and disease prognosis. Methods: Between October 2001 and October 2003, 70 AKI patients with a serum creatinine level greater than 1.4 mg/dl and blood urea greater than 53 mg/dl were enrolled in this retrospective study at Wenlock district hospital, Mangalore, KMC hospital Attawar, Mangalore, and KMC hospital, Jyothi circle, Mangalore. Results: Amongst the enrolled patients, 45.7% of patients were in the 40-60 years age group, 49 males with no significant (p=0.412) gender difference. The most common presenting symptom was decreased micturition, which was present in 47.1 percent of patients, and the most common aetiology of AKI was sepsis, which was also associated with the highest (17.1 percent) mortality. The mortality rate for patients who had conservative treatment (n=52) was 42.8 percent, while the mortality rate for those who received hemodialysis (n=18) was 4.2 percent. The overall survival rate in the study was 52.9%. Conclusions: The epidemiological data in this study is consistent with prior studies in India, with hemodialysis appearing to have better disease outcomes than conservative therapy.
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