肾功能急性减退慢性肾脏疾病患者的临床分析

发布时间：2018-07-31 13:53

【摘要】：目的：探讨肾功能急性减退的慢性肾脏疾病患者发病的基本情况、诱发因素、治疗选择及疗效和预后,以期降低ACKI的发病率。方法：回顾性分析2011年1月至2012年2月在兰州大学第二医院肾内科住院ACKI患者的诱发原因、易感疾病、治疗、疗效和预后。结果：ACKI患者共55例,占同期入院CKD患者的5.2%。肾病综合征、慢性间质性肾炎及糖尿病肾病患者极易发生ACKI,诱发ACKI的常见原因分别感染(30.9%)、原发病加重(29.1%)和使用可能致肾脏损伤药物(12.7%)。治疗有效患者38例,积极控制原发病(59.5%)、有效治疗感染(10.5%)及停用可能致肾脏损伤药物(2.6%)是ACKI患者肾功能逆转的重要措施；无效患者17例,与治疗有效的患者相比,其高血压、高血压肾病及并发合并症的患者比例较高(P0.05)。随访时间7.1±3.8月,治疗有效组29例,治疗无效组15例,两组比较：肾功能好转率分别为34.2%vs5.9%,P0.05,肌酐倍增率分别为23.7%vs29.4%,终末期肾功能衰竭发生率分别为7.9%vs29.4%,P0.05,死亡率分别为10.5%vs23.5%。12个月肌酐倍增发生率分别为：有效组17%,无效组62%(P0.05)。高血压及存在合并症是发生肌酐倍增的风险因素。结论：ACKI不能有效逆转则使肾脏预后恶劣,对CKD尤其是肾病综合征、慢性间质性肾炎及糖尿病肾病的患者管理中,应谨防感染、治疗不正规及使用可能致肾脏损伤药物等诱发ACKI的因素,及早救治极为迫切。
[Abstract]:Objective: to investigate the basic condition, inducing factors, treatment choice, curative effect and prognosis of patients with chronic renal disease with acute hypofunction of renal function, in order to reduce the incidence of ACKI. Methods: from January 2011 to February 2012, the causes, susceptibility, treatment, curative effect and prognosis of ACKI patients in Department of Renal Medicine, second Hospital of Lanzhou University were analyzed retrospectively. Results there were 55 patients with CKD in the same period, accounting for 5.2%. Patients with nephrotic syndrome, chronic interstitial glomerulonephritis and diabetic nephropathy were easy to develop ACKI, the common causes of ACKI were infection (30.9%), the primary disease was aggravated (29.1%) and the use of drugs might cause renal injury (12.7%). 38 effective patients, active control of primary disease (59.5%), effective treatment of infection (10.5%) and discontinuation of drugs that may cause renal injury (2.6%) are important measures to reverse renal function in patients with ACKI. The proportion of patients with hypertension nephropathy and complicated diseases was higher (P0.05). The follow-up time was 7.1 卤3.8 months. There were 29 cases in the effective group and 15 cases in the ineffective group. Comparison between the two groups: the improvement rate of renal function was 34.2vs5.9 + P0.05, the creatinine doubling rate was 23.7vs29.4. the incidence of end-stage renal failure was 7.9vs29.4cm P0.05.The mortality rate was 10.5%vs23.5%.12 month creatinine doubling rate was 17175.The rate of creatinine doubling in ineffective group was 62% (P0.05). Hypertension and complications are risk factors for creatinine doubling. Conclusion the prognosis of CKD, especially the patients with nephrotic syndrome, chronic interstitial glomerulonephritis and diabetic nephropathy can not be reversed effectively. The infection should be taken care of in the management of patients with CKD, especially nephrotic syndrome, chronic interstitial glomerulonephritis and diabetic nephropathy. It is urgent to treat ACKI as soon as possible because of irregular treatment and the use of drugs that may cause renal injury.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692

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