恶性肿瘤患者急性肾损伤的流行病学及相关因素:本哈大学医院内科血液与肿瘤科住院病人数据库分析

Mohamed A. Mohamed, Abdelmoneim Ahmed, H. Eleleimy, Ahmed E Mansour, Shireen Mohsen Salem
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摘要

:背景:急性肾损伤(AKI)是癌症患者最严重的并发症之一。本研究旨在检测癌症患者急性肾损伤的发生率,发现哪些临床因素会增加急性肾损伤的风险,并评估急性肾损伤对院内死亡率和住院时间的影响。研究方法这项前瞻性队列研究的对象是 276 例恶性肿瘤患者(AKI:40 例,无 AKI:236 例)。每三周测量一次血清肌酐、血尿素、全血细胞计数、尿酸、电解质 "钾、钠、钙"、尿液分析,并对 RBC 进行评论,肝功能检测 "ALT、AST、白蛋白和胆红素",化疗前和治疗结束后进行尿白蛋白肌酐比值检测。结果:癌症病人原有的合并症,包括高血压(HTN)、糖尿病(DM)和冠心病,是增加其发生 AKI 风险的重要预测因素。低钠血症、低钾血症和高尿酸血症患者发生 AKI 的风险明显更高(OR = 2.95、2.49 和 3.01)。Cox 回归分析显示,调整人口统计学和临床特征后,高血压和糖尿病也会增加死亡风险。与无 AKI 组相比,有 AKI 组的平均存活率明显较低(16.331 对 19.589)。与 AKI I 期相比,AKI II 期和 III 期的中位住院时间更长。
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Epidemiology of Acute Kidney Injury and Associated Factors among Patients with Malignancy: Analysis of Hospital Inpatients Database in Benha university Hospital Internal Medicine Departement, Hematology and Oncology Unit
: Background: One of the most serious complications among cancer patients is Acute Kidney Injury (AKI). This study aimed to detect the AKI incidence in cancer patients, to discover which clinical factors could increase the risks of AKI, and to assess the effect of AKI on in-hospital mortality, length of stay. Methods: This prospective cohort study was conducted on 276 malignant patients (AKI: 40 cases and no AKI: 236 cases). Serum creatinine, blood urea, complete blood count, uric acid, Electrolyte'' potassium, sodium, calcium'', urine analysis with comment on RBCs cast, liver function test'' ALT, AST, Albumin and bilirubin'' were measured every three weeks, and urine albumin creatinine ratio was done before chemotherapy and after finishing treatment. Results: pre-existing comorbidities including hypertension (HTN), diabetes (DM), and coronary heart disease are significant predictors for increased risk of AKI in cancer patients. Patients with hyponatremia, hypokalemia and hyperuricemia shared a significantly higher risk of AKI (a OR = 2.95, 2.49, and 3.01). Cox regression analysis revealed that HTN and DM also increased the mortality risk when adjusting demographic and clinical features. The mean survival rate was significantly lower in group with AKI compared to group without AKI (16.331 versus 19.589). AKI stage II and III had longer median length of hospital stay compared to stage I.
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