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首页> 外文期刊>BMC Anesthesiology >Incidence and outcome of contrast-associated acute kidney injury assessed with Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients of medical and surgical intensive care units: a retrospective study
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Incidence and outcome of contrast-associated acute kidney injury assessed with Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients of medical and surgical intensive care units: a retrospective study

机译：通过风险，伤害，失败，丢失和终末期肾脏病（RIFLE）标准评估的医疗和外科重症监护病房危重患者中对比相关的急性肾损伤的发生率和结果：一项回顾性研究

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Background Contrast medium used for radiologic tests can decrease renal function. However there have been few studies on contrast-associated acute kidney injury in intensive care unit (ICU) patients. The objective of this study was to evaluate the incidence, characteristics, and outcome of contrast-associated acute kidney injury (CA-AKI) patients using the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria in critically ill patients in the ICU. Methods We conducted a retrospective study of adult patients who underwent contrast-enhanced radiologic tests from January 2011 to December 2012 in a 30-bed medical ICU and a 24-bed surgical ICU. Results The study included 335 patients, and the incidence of CA-AKI was 15.5%. The serum creatinine and estimated glomerular filtration rate values in the CA-AKI patients did not recover even at discharge from the hospital compared with the values prior to the contrast use. Among 52 CA-AKI patients, 55.8% (n?=?29) had pre-existing kidney injury and 44.2% (n?=?23) did not. The CA-AKI patients were divided into risk (31%), injury (31%), and failure (38%) by the RIFLE classification. The percentage of patients in whom AKI progressed to a more severe form (failure, loss, end-stage kidney disease) increased from 38% to 45% during the hospital stay, and the recovery rate of AKI was 17% at the time of hospital discharge. Because the Acute Physiology and Chronic Health Evaluation (APACHE) II score was the only significant variable inducing CA-AKI, higher APACHE II scores were associated with a higher risk of CA-AKI. The ICU and hospital mortality of patients with CA-AKI was significantly higher than in patients without CA-AKI. Conclusions CA-AKI is associated with increases in hospital mortality, and can be predicted by the APACHE score.
机译：背景用于放射学检查的造影剂会降低肾功能。但是，关于重症监护病房（ICU）患者的对比相关急性肾损伤的研究很少。这项研究的目的是使用风险，伤害，失败，丢失和终末期肾脏病（RIFLE）标准来评估对比相关的急性肾损伤（CA-AKI）患者的发病率，特征和结局重症监护病房的病人。方法我们回顾性研究了从2011年1月至2012年12月在30张病床的ICU和24张病床的ICU中接受对比增强放射学检查的成年患者。结果该研究纳入335例患者，CA-AKI的发生率为15.5％。与使用对比剂之前相比，CA-AKI患者的血清肌酐和肾小球滤过率估计值即使在出院后也没有恢复。在52名CA-AKI患者中，有55.8％（n？=？29）曾有肾脏损伤，而有44.2％（n？=？23）没有。通过RIFLE分类将CA-AKI患者分为风险（31％），损伤（31％）和失败（38％）。在住院期间，AKI进展为更严重形式（失败，丢失，终末期肾脏疾病）的患者百分比从38％增加到45％，并且住院时AKI的恢复率为17％卸货。由于急性生理和慢性健康评估（APACHE）II分数是唯一诱发CA-AKI的显着变量，因此较高的APACHE II分数与较高的CA-AKI风险相关。患有CA-AKI的患者的ICU和医院死亡率显着高于没有CA-AKI的患者。结论CA-AKI与医院死亡率的增加有关，并且可以通过APACHE评分进行预测。

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