非血液系统恶性肿瘤并发急性肾损伤住院患者预后的影响因素分析
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摘要
目的探讨非血液系统恶性肿瘤并发急性肾损伤(AKI)住院患者预后的影响因素。方法选择非血液系统恶性肿瘤并发AKI住院患者72例为研究对象,收集其相关临床资料,采用Logistic回归模型分析非血液系统恶性肿瘤并发AKI患者肾功能预后和住院生存预后的影响因素。结果非血液系统恶性肿瘤患者的AKI发生率为2. 1%(72/3 423),住院病死率为47. 2%(34/72)。多因素回归分析结果显示,对于非血液系统恶性肿瘤并发AKI患者,AKI分期是肾功能预后的影响因素,多器官功能衰竭是住院生存预后的影响因素(均P <0. 05)。结论非血液系统恶性肿瘤并发AKI患者住院病死率较高,AKI分期高和合并多器官功能衰竭分别是其肾功能预后差和住院死亡的危险因素。
Objective To explore the factors influencing the prognosis of inpatients with non-hematological malignant tumors complicated with acute kidney injury( AKI). Methods Seventy-two inpatients with non-hematological malignant tumors complicated with AKI were selected as the subjects and their clinical data were collected. Factors influencing the prognosis of renal function and in-hospital survival in patients with non-hematological malignancies complicated with AKI were analyzed by Logistic regression model. Results The incidence of AKI in non-hematological malignant tumors was 2. 1%( 72/3 423),and the hospital mortality was 47. 2%( 34/72). Multivariate regression analysis showed that AKI stage was the influencing factor of prognosis of renal function,and multiple organ failure was the influencing factor of prognosis of in-hospital survival in patients with non-hematological malignant tumors complicated with AKI( all P < 0. 05). Conclusion Patients with non-hematological malignancies complicated with AKI have a high mortality in hospital,and high AKI staging and multiple organ failure are their risk factors for poor renal function prognosis and in-hospital death,respectively.
Objective To explore the factors influencing the prognosis of inpatients with non-hematological malignant tumors complicated with acute kidney injury( AKI). Methods Seventy-two inpatients with non-hematological malignant tumors complicated with AKI were selected as the subjects and their clinical data were collected. Factors influencing the prognosis of renal function and in-hospital survival in patients with non-hematological malignancies complicated with AKI were analyzed by Logistic regression model. Results The incidence of AKI in non-hematological malignant tumors was 2. 1%( 72/3 423),and the hospital mortality was 47. 2%( 34/72). Multivariate regression analysis showed that AKI stage was the influencing factor of prognosis of renal function,and multiple organ failure was the influencing factor of prognosis of in-hospital survival in patients with non-hematological malignant tumors complicated with AKI( all P < 0. 05). Conclusion Patients with non-hematological malignancies complicated with AKI have a high mortality in hospital,and high AKI staging and multiple organ failure are their risk factors for poor renal function prognosis and in-hospital death,respectively.
引文
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[13] Coca SG,Yusuf B,Shlipak MG,et al. Long-term risk of mortality and other adverse outcomes after acute kidney injury:a systematic review and meta-analysis[J]. Am J Kidney Dis,2009,53(6):961-973.
[14]陆任华,方燕,高嘉元,等.住院患者急性肾损伤的发病及预后相关危险因素分析[J].中华肾脏病杂志,2012,28(3):194-200.
[15] Maccariello E,Valente C,Nogueira L,et al. Outcomes of cancer and non-cancer patients with acute kidney injury and need of renal replacement therapy admitted to general intensive care units[J]. Nephrol Dial Transplant,2011,26(2):537-543.
[16] Gong Y,Zhang F,Ding F,et al. Elderly patients with acute kidney injury(AKI):clinical features and risk factors for mortality[J]. Arch Gerontol Geriatr,2012,54(2):e47-e51.
[2] Ganguli A,Sawinski D,Berns JS. Kidney diseases associated with haematological cancers[J]. Nat Rev Nephrol,2015,11(8):478-490.
[3] Lameire N,Vanholder R,Van Biesen W,et al. Acute kidney injury in critically ill cancer patients:an update[J]. Crit Care,2016,20(1):209.
[4] James M,Bouchard J,Ho J,et al. Canadian Society of Nephrology commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury[J]. Am J Kidney Dis,2013,61(5):673-685.
[5]王宇明,朱鹏.终末期肝病中的急性肾损伤与肝肾综合征[J].中华肝脏病杂志,2013,21(3):173-176.
[6]陈杰,高绍华.肝硬化患者急性肾损伤的诊治进展[J].中华肝脏病杂志,2016,24(10):797-800.
[7] Wong F. Acute kidney injury in liver cirrhosis:new definition and application[J]. Clin Mol Hepatol,2016,22(4):415-422.
[8] Cohen EP,Krzesinski JM,Launay-Vacher V,et al. Onconephrology:core curriculum 2015[J]. Am J Kidney Dis,2015,66(5):869-883.
[9] Hoste EA,Bagshaw SM,Bellomo R,et al. Epidemiology of acute kidney injury in critically ill patients:the multinational AKI-EPI study[J]. Intensive Care Med,2015,41(8):1 411-1 423.
[10]刘雪梅,刘孟春,马瑞霞,等.恶性肿瘤伴发急性肾损伤患者的临床特点分析[J].中华肾脏病杂志,2014,30(11):813-818.
[11] Qin Y,Xu Q,Xu T,et al. Clinical characteristics of patients with malignancies combined with acute kidney injury[J].Int J Clin Exp Med,2015,8(7):11 529-11 533.
[12]董文霞,俞娅芬,彭俊琼,等.住院肿瘤患者急性肾损伤的发病及预后相关危险因素分析[J].中国中西医结合肾病杂志,2016,17(2):145-148.
[13] Coca SG,Yusuf B,Shlipak MG,et al. Long-term risk of mortality and other adverse outcomes after acute kidney injury:a systematic review and meta-analysis[J]. Am J Kidney Dis,2009,53(6):961-973.
[14]陆任华,方燕,高嘉元,等.住院患者急性肾损伤的发病及预后相关危险因素分析[J].中华肾脏病杂志,2012,28(3):194-200.
[15] Maccariello E,Valente C,Nogueira L,et al. Outcomes of cancer and non-cancer patients with acute kidney injury and need of renal replacement therapy admitted to general intensive care units[J]. Nephrol Dial Transplant,2011,26(2):537-543.
[16] Gong Y,Zhang F,Ding F,et al. Elderly patients with acute kidney injury(AKI):clinical features and risk factors for mortality[J]. Arch Gerontol Geriatr,2012,54(2):e47-e51.