Analysis Of Risk Factors And Prognosis In Patients With Acute Kidney Injury

Objective:This study was to understand the incidence of acute kidney injury(AKI),the cause and long-term prognosis of patients with acute kidney injury in Zhongda Hospital Affiliated to Southeast University,in order to provide a better understanding,diagnosis,treatment and prevention of the diseaseMaterial and methods:We used the information section of Zhongda Hospital Affiliated to Southeast University of His system to screen all the patients in the hospital from January 2013 to December.All patients who had AKI during hospitalization were screened by diagnostic criteria for AKI clinical practice guidelines issued in 2012 by Kidney Disease:Improving Global Outcomes(KDIGO).The clinical features,incidence,etiology,long-term prognosis of the patients with AKI in hospitalized patients were retrospectively analyzed.Logistic regression analysis was used to analyze the risk factors of appearing AKI and long-term renal outcome in AKI patientsResults:There were 1282 patients who met with the diagnostic criteria of acute kidney injury(AKI)in 2013 of the whole 43314 admissions during the study period.The morbidity of AKI was 2.96%.Male 741 cases,female 541 cases,male:female 1.37:1.The average age of patients was(68.548±15.926)years.The total mortality rate of the all patients was 1.05%,The mortality rate of AKI patients was 14.1%.All AKI patients were distributed in 25 departments of the hospital.698 cases(54.4%)were internal medicine patients,441(34.4%)patients with surgical department.143 cases(11.2%)were ICU patients,.The incidence rate of patients in Department of Cardiology ranks first321cases(25.0%),the second department was ICU 143cases(11.1%)Urology Surgery 118cases(9.2%),Department of general surgery in 101 cases(7.9%).The traditional view that the higher incidence of kidney disease is only 53 cases(4.1).Etiological composition Pre renal factor 61.6%(790/1282),In the treatment of arrhythmia,acute coronary syndrome,acute heart failure,surgical procedures,and patients with infection.Renal factor 33.3%(427/1282),Patients underwent AKI before a week of surgery and use of contrast agents in patients with renal factors 33.3%(427/1282),traditional Chinese medicine,Renal toxicity,CKD disease were the main cause.After renal factors accounted for 5.1%(66/1282),The main reasons were urinary calculi,urinary system and the surrounding system of tumor.The diagnostic rate of AKI was 11.4%(146/1282)on the first page of medical records.The rate of missed diagnosis was 88.6%(1136/1282).internal medicine,The diagnosis rate in the Kidney and ICU is more higher than the other departments.CKD,infection,surgical history,coronary heart disease,diuretic use is a risk factor for the occurrence of AKI in hospitalized patients with Single factor regression analysis.Infection,coronary heart disease,surgery,and diuretic use were independent risk factors for AKI in hospitalized patients with Multi factor regression analysis.AKI patients were followed up after discharge,in addition to the death of patients,1 years after the detection of renal function in patients with only 380 people,while only 3 of the 149 years of renal function testing.The prevalence of CKD in follow-up patients was 22.9%and 35.6%.Conclusion:1、There was a high incidence of AKI and mortality in Hospitalized patients.The diagnostic rate of AKI was low,while the rate of missed diagnosis was high.2.Pre renal factor still remains the main cause of AKI in hospitalized patients,the follow factors was the renal factors and Post renal factor.3.Infection,coronary heart disease,AKI before the operation history,diuretic use is hospitalized patients with AKI independent risk factors.4.Diuretic and CKD diseases are risk factors for prognosis.5.It is important for us to Early diagnosis earlier,prevention earlier and treat earlier to improve the survival rate and improve the prognosis of patients.