社区获得性急性肾损伤的临床概况和影响预后的因素:三个月随访研究

Pub Date : 2024-07-15 DOI:10.25259/ijn_352_23
Rajesh Tarachandani, L. Pursnani, M. Balakrishnan, H. Mahapatra, Sutanay Bhattacharyya, Preeti Chaudhary, Vipul Gupta
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引用次数: 0

摘要

社区获得性急性肾损伤(CA-AKI)通常是一种破坏性临床综合征,伴有较高的住院死亡率。此外,有关社区获得性急性肾损伤预后的前瞻性数据十分有限。因此,我们开展了这项随访研究,以评估CA-AKI的临床概况和影响预后的因素。这项前瞻性研究在 2021 年至 2022 年期间招募了 283 名参与者,其中包括根据肾病改善全球预后(KDIGO)标准定义的 AKI 患者。研究人员收集了有关人口统计学、临床特征和病因学因素的数据。对患者进行了为期三个月的随访。采用单变量和多项式分析预测结果。患者的平均年龄为(41.67±16.21)岁,男性居多。大多数患者需要非重症监护室护理(81.9%)。约 36% 和 39.6% 的 AKI 患者分别出现少尿和需要透析。大多数患者的病因单一,最常见的病因是败血症。大多数患者处于 KDIGO 3 期,其次是 2 期。在三个月的随访中,分别有 40.6%、12.3% 和 4.2% 的患者完全康复、部分康复和未康复,30.4% 的患者死亡。年龄、单一病因、肝肾综合征、脓毒症、需要机械通气和血管加压、合并症和肾小球肾炎与死亡率显著相关。这凸显了预防、早期发现和干预 AKI 的迫切需要,以减少可逆的风险因素并优化临床结果。
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Clinical Profile and Predictors Affecting Outcome in Community-Acquired Acute Kidney Injury: A 3 Months Follow-Up Study
Community-Acquired Acute Kidney Injury (CA-AKI) is often a devastating clinical syndrome allied with high hospital mortality. Moreover, only limited prospective data exist on the outcomes of CA-AKI. Hence, this follow-up study was conducted to assess clinical profiles and the factors affecting outcomes in CA-AKI. A prospective study enrolling 283 participants was conducted from the year 2021 to 2022. AKI patients defined as per Kidney Disease Improving Global Outcomes (KDIGO) criteria were included. Data were collected on demographics, clinical features, and etiological factors. Patients were followed for three months. Univariate and multinomial analyses were done to predict outcomes. The Cox regression model was fitted to identify predictors of mortality. The mean age of patients was 41.67±16.21 years with male predominance. Most of the patients required non-ICU (81.9%) care. Around 36% and 39.6 % of AKI patients were oliguric and required dialysis, respectively. Most patients had a single etiology, with sepsis being the most common cause. Most patients were in KDIGO stage 3, followed by stage 2. At three months of follow-up, 40.6%, 12.3%, and 4.2% had complete, partial, and non-recovery, respectively, and 30.4% died. Age, single etiology, hepatorenal syndrome, sepsis, requirement of mechanical ventilation and vasopressors, comorbidities and glomerulonephritis were significantly associated with mortality. CA-AKI is significantly associated with higher mortality, even for those patients who require non-ICU care on presentation. This highlights the pressing need for AKI prevention, early detection, and intervention to mitigate reversible risk factors and optimize clinical outcomes.
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