[急性肾损伤合并严重心血管并发症患者死亡的危险因素]。

Przeglad lekarski Pub Date : 2016-01-01
Ewa Ignacak, Grażyna Wyrwicz-Zielińska, Izabela Krzysztonek-Weber, Władysław Sułowicz
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摘要

急性肾损伤(AKI)是心血管疾病患者常见且严重的并发症。该研究的目的是评估AKI合并严重心血管疾病患者的死亡风险。材料与方法:回顾性分析2000-2011年246例(男性157例,女性89例,年龄67.9±14.8岁)患有严重心血管疾病、重症监护病房住院、肾脏特征的AKI患者的调查结果。结果:绝大多数AKI患者(95.9%)需要血液透析治疗。研究组患者死亡率高,达69.5%,肾功能恢复39例(27.3%)。116例患者(47.2%)在AKI发病前存在肾脏疾病。动脉高血压患者少尿发生率更高(p = 0.001),需要更多的血液透析疗程(p = 0.029),住院时间更长(p = 0.012)。在多变量分析中,死亡的发生取决于以下因素:肾功能未恢复、胃肠道出血、尿路感染以及其他感染性和非感染性并发症。结论:急性肾损伤合并严重心血管疾病时,肾功能无恢复,且合并并发症增加死亡风险。
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[Risk factors of death occurrence in patients with acute kidney injury in the course of severe cardio-vascular complications].

Introduction: Acute kidney injury (AKI) is a frequent and serious complication in patients with cardiovascular disease. The aim of the study was to evaluate the risk of death in patients with AKI complicating severe cardiovascular diseases.

Material and methods: A retrospective analysis of 246 patients surveys (157 men and 89 women aged 67.9 ± 14.8 years) with AKI in the course of severe cardiovascular diseases, hospitalized in intensive care units and words of nephrological profile in years 2000-2011 were performed.

Results: The majority of patients (95.9%) with AKI required hemodialysis treatment. The mortality rate in the study group was high and amounted to 69.5% and the recovery of renal function was observed in 39 patients (27.3%). Kidney disease before the onset of AKI was observed in 116 patients (47.2%). Patients with arterial hypertension have more frequently oligoanuria (p = 0.001), needs more hemodialysis sessions (p = 0.029) and stay longer in hospital (p = 0.012). In multivariate analysis, the occurrence of death depend on such factors as: the lack of recovery of renal function, bleeding from gastrointestinal tract, urinary tract infections, and other infectious and noninfectious complications.

Conclusions: No recovery of renal function and comorbidity while AKI in the course of severe cardiovascular diseases increase the risk of death.

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