严重腹泻引发的老年人急性肾损伤及其后果

Chang-Gue Son
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摘要

方法本研究对一名因严重脱水而被诊断为急性肾损伤(AKI)的老年男性患者进行了全面的病例研究,并对实验室结果进行了长期随访:一名 83 岁的男性患者在一夜之间出现严重腹泻,因脱水和低血压症状而住院治疗。他的化验结果显示出典型的 AKI 模式,包括肌酐水平显著升高(5.19 毫克/分升)以及高钾血症和低钠血症。经过一般治疗,包括服用一种草药(Bulhwangeumjeonggi-san),估计肾小球滤过率(eGFR)在五天内从 10 毫升/分钟(第 5 阶段)提高到 34 毫升/分钟(第 3 阶段),随后出院。虽然随后在门诊进行的 1 个月和 2 个月的肾小球滤过率检测显示患者的肾小球滤过率提高了 42 毫升/分钟,但患者仍因此出现了轻度慢性功能障碍:本研究提供了一例值得注意的严重脱水导致的急性肾损伤病例,强调了医学界对腹泻引起的肾功能损伤的认识的重要性,尤其是在老年人群中。
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Severe Diarrhea-induced Acute Kidney Injury and Its Consequence in an Elderly
Methods: This study presents a comprehensive case study of an elderly male diagnosed with acute kidney injury (AKI) resulting from severe dehydration, supported by an extended follow-up with laboratory findings.Results: An 83-year-old male patient experienced severe diarrhea overnight, leading to hospitalization due to symptoms of dehydration and hypotension. His laboratory results displayed a typical AKI pattern, including a significant increase in creatinine levels (5.19 mg/dL) and the presence of hyperkalemia and hyponatremia. Following general treatments, including the administration of an herbal drug (Bulhwangeumjeonggi-san), the estimated glomerular filtration rate (eGFR) improved from 10 ml/min (Stage 5) to 34 ml/min (Stage 3) within five days when he was discharged. Although subsequent eGFR tests, conducted one and two months later as an outpatient, revealed an improvement of 42 ml/min, the patient still experienced mild chronic dysfunction as a consequence.Conclusion: This study presents a noteworthy case of acute kidney injury attributed to severe dehydration, emphasizing the importance of medical awareness regarding diarrhea-induced kidney function impairment, especially in the elderly population.
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