Clinical And Renal Pathological Features Of 115 Patients With Acute Kidney Injury And Short-term Prognosis Analysis

Objective:1.To Analyze the clinical characteristics and renal pathological features of patients with acute kidney injury（AKI）;2.To explore the risk factors affecting the short-term prognosis of AKI.Methods:A retrospective cohort study was designed.The patients diagnosed with AKI and did renal biopsy were enrolled from Ningxia Medical University Hospital during the January 1^st,2008 to the January 31^st,2019.The information of baseline demographic characteristics,laboratory test items and pathological data of the patients were collected.The recovery of renal function of all patients in 1 year of discharge was followed up until January31^st,2020.According to the clinical practice guidelines of KDIGO AKI in 2012,the study subjects were divided into AKI 1 phase,AKI 2 phase and AKI 3 phase.According to the WHO（1995）revision plan for the classification of glomerular diseases,the clinical characteristics and prognosis of patients with different pathological types were compared.In 1year,renal function was divided into two groups according to eGFR≥60 mL/min/1.73 m² and<60 mL/min/1.73 m²,clinical and laboratory indicators of the two groups were compared,and risk factors affecting short-term renal prognosis of AKI were analyzed by logistic regression.Results:（1）There were 115 patients,including 66 males（57.4%）and 49 females（42.2%）,with an average age of 45.7±14.62 years.（2）Comparison of general clinical data and laboratory indicators for different AKI stages:66 cases（57.4%）of AKI stage 1,23 cases（20.0%）of AKI stage 2,and 26 cases（22.6%）of AKI stage 3.Hospitalization stay,hospitalization cost,serum creatinine,blood urea nitrogen were all significantly different among the three groups （p<0.05）.（3）Distribution of pathological types of AKI patients:26 cases（22.6%）of minimal change disease,15 cases（13.0%）of membranous nephropathy,19 cases（16.5%）of acute interstitial nephritis,etc.（4）Comparison of clinical and laboratory indicators for different pathological types:compared with other types,patients with minimal change disease had lower serum albumin,higher triglyceride and higher proteinuria.Hematuria was more common in IgA nephropathy,and anemia was more common in acute interstitial nephritis （p<0.05 compared with other types）.（5）Renal function of patients with AKI was followed up in 1 year after discharge.84 patients（73.04%）had eGFR≥60 mL/min/1.73 m²,and 31 patients（26.96%）had eGFR<60 mL/min/1.73 m².Compared with other pathological types,renal function in IgA nephropathy progressed to stage CKD3-5 at a higher rate.（6）Age（p=0.024）,systolic blood pressure（p=0.006）,and serum creatinine（p=0.012）at discharge were independent risk factors for renal function progression to stage CKD3-5 in AKI patients.Conclusion:1.The higher the AKI stage,the higher the hospitalization cost of patients.The patients in AKI2 and AKI3 have longer hospital stays than patients in AKI1.2.Minimal change disease and acute interstitial nephritis were common in pathological types of AKI.3.Age,systolic blood pressure and serum creatinine at discharge are independent risk factors for renal function progression to stage CKD3-5 in patients with AKI.