KDIGO急性肾脏病定义对住院患者急性肾功能不全的诊断价值

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Abstract Objective: To investigate the incidence and clinical characteristics of acute renal impairment in hospitalized patients using the 2012 Kidney Disease Improving Global Outcomes (KDIGO) definition-acute kidney disease (AKD) and assessed the risk factors associated with the adverse outcome of AKD. Methods: A retrospective analysis of 1984 patients receiving treatment in the ward of Renal Division of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 1st 2016 to December 31st 2016, using the 2012 KDIGO AKD/AKI definitions to identify patients with AKD (AKI and non-AKI AKD). The incidence, clinical characteristics and prognosis of AKI and AKD non-AKI patients were compared. Logistic regression was used to identify risk factors associated with adverse outcomes of AKD. Results: A total of 105 patients (5.29%) were diagnosed with AKD, of which 70 met the AKI criteria and 35 were classified as non-AKI AKD. Pre-renal, intrinsic and post-renal AKD accounted for 43.8%, 40.0% and 3.8% respectively. Compared with AKI patients, patients diagnosed with non-AKI AKD had higher proportion of co-morbidity and higher 24-hour proteinuria, lower serum albumin and slower serum creatinine (Scr) rising velocity. Logistic regression revealed that systolic blood pressure (OR=1.03), CKD history (OR=4.95), Scr rising velocity (OR=0.98) and hemoglobin (OR=0.96) were independent risk factors for adverse renal outcomes of AKD. Conclusion: The 2012 KDIGO AKD criteria identified more patients with acute renal impairment. Higher systolic blood pressure, CKD history, lower Scr rising velocity and lower Hemoglobin were independent risk factors for adverse outcome of AKD. AKD patients diagnosed as non-AKI had the same renal prognosis compared with the patients who met the AKI criteria. The results of this study underline the value of AKD diagnostic criteria and support its application in the clinical practice.

Key words： acute kidney disease acute kidney injury incidence risk factors

Received: 14 February 2018

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	ZONG Xue
	LIN Fujun
	JIANG Gengru

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I7/504

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