摘要
目的 探讨慢性肾脏疾病（chronic kidney disease,CKD）急性加重（acute on chronic kidney disease,A/C）的相关因素及其预后并加以分析.方法 对2011年1月至2012年2月住院的A/C患者55例,按其基础疾病、加重因素、好转因素、治疗方式和预后进行回顾性总结.结果 A/C基础疾病以肾病综合征（27.3％）、慢性间质性肾炎（14.5％）、糖尿病肾病（14.5％）、高血压性肾病（10.9％）为主.A/C加重因素依次为感染（32.7％）、原发病加重（29.1％）、肾毒性药物（12.7％）、不规则使用激素及免疫抑制剂（5.5％）等,7例同时存在≥2种病因（12.7％）.积极行透析及非透析治疗后住院期间肾功能好转者38例.随访时间7.6＆#177;4.4个月,其中随访44例,失访11例.随访期间肾功能正常或明显好转患者14例（31.8％）、肌酐倍增患者14例（31.8％）、终末期肾功能衰竭患者8例（18.2％）、死亡患者8例（18.2％）,死亡原因主要为多脏器功能衰竭,其中5例为老年患者.结论 对于A/C加重因素多可逆,但远期预后不佳,应重视A/C发生的加重因素并及早发现,争取在最大程度改善肾功能,降低病死率,延长患者生命.
Objectives To investigate and analyse the related factors of acute-on-chronic kidney diseases（A/C） and its prognosis.Methods Clinic data from all patients diagnosed as A/C for one year period（Jan,2011 to Feb,2012） were collected,and the underlying disease,factors of aggravation and improvement,therapy method and results of follow-up were summarized retrospectively.Results The underlying diseases of A/C were mainly nephrotic syndrome （27.3 %）、Chronic Interstitial Nephritis （14.5 %）、diabetic nephropathy （14.5 %） and Hypertensive kidney disease（10.9%）.The aggravated factors were infection（32.7%） 、aggravation of underlying diseases （29.1%） 、nephrotoxicity drug （12.7 %） 、non-standard usage of hormone and immune inhibitor （5.5 %）,etc.Seven cases have more than 2 kinds of factors（12.7%）.After positive dialysis treatment and non-dialysis treatment,the renal function improved in 38 cases while in hospital.The follow-up time were 7.6 ＆#177; 4.4 months,44 cases were follow-up,while 11 cases were lost.During the follow-up time,the renal function returned to normal level or markedly improved in 14 cases（31.8%）,serum creatinine multiplication in 14 cases（31.8%）,patients with end-stage renal failure were 8（18.2%）,and 8 cases died（18.2%）,the death cases were mainly multiple organ failure and 5 were elderly patient.Conclusions Most of the aggravated factors of A/C were reversible,but the long-term prognosis was poor,the aggravated factors should be paid high attention to and actively found out to strive for the maximum improvement of kidney function,reduce the case fatality rate and prolong patient＆#39;s life time.
出处
《国际泌尿系统杂志》
2014年第2期208-212,共5页
International Journal of Urology and Nephrology
关键词
肾疾病
慢性病
Kidney Disease
Chronic Disease
