机构：[1]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China[2]Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China首都医科大学附属同仁医院[3]Department of Emergency Medicine, First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan 650032, China内科科室急诊医学科昆明医科大学附属第一医院云南省第一人民医院[4]Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei 430030, China华中科技大学同济医学院附属同济医院[5]Department of Critical Care Medicine, Guangdong General Hospital, Guangzhou, Guangdong 510080, China其他科室急危重症医学部广东省人民医院[6]Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200025, China[7]Department of Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China[8]Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China[9]Department of Critical Care Medicine, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China[10]Department of Emergency and Critical Care Medicine, The Second Hospital of Jilin University, Changchun, Jilin 130041, China[11]Department of Critical Care Medicine, Zhejiang Provincial People’s Hospital, Hangzhou, Zhejiang 310014, China[12]Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, Shijiazhuang, Hebei 050011, China河北医科大学第四医院[13]Department of Critical Care Medicine, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, China[14]Department of Critical Care Medicine, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China外科系统重症医学科重庆医科大学附属第一医院[15]Department of Critical Care Medicine, Hainan Provincial People’s Hospital, Haikou, Hainan 570311, China[16]Department of Critical Care Medicine, Affiliated Hospital of Inner Mongolia Medical College, Huhhot, Inner Mongolia 010050, China[17]Department of Critical Care Medicine, Peking University People’s Hospital, Beijing 100044, China[18]Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China四川大学华西医院[19]Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China[20]Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang 830054, China[21]Department of Critical Care Medicine, The First Affiliated Hospital, Haerbin Medical University, Haerbin, Heilongjiang 150001, China[22]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
Background Acute kidney injury (AKI) has been recognized as a major healthcare problem affecting millions of patients worldwide. However, epidemiologic data concerning AKI in China are still lacking. The objectives of this study were to characterize AKI defined by RIFLE criteria, assess the association with hospital mortality, and evaluate the impact of AKI in the context of other risk factors. Methods This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across mainland China. We excluded patients who were admitted for less than 24 hours (n=1623), younger than 18 years (n=127), receiving chronic hemodialysis (n=29), receiving renal transplantation (n=1) and unknown reasons (n=28). There were 1255 patients in the final analysis. AKI was diagnosed and classified according to RIFLE criteria. Results There were 396 patients (31.6%) who had AKI, with RIFLE maximum class R, I, and F in 126 (10.0%), 91(7.3%), and 179 (14.3%) patients, respectively. Renal function deteriorated in 206 patients (16.4%). In comparison with non AKI patients, patients in the risk class on ICU admission were more likely to progress to the injury class (odds ratio (OR) 3.564, 95% confidence interval (Cl) 1.706-7.443, P = 0.001], while patients in the risk class (OR 5.215, 95% CI 2.798-9.719, P <0.001) and injury class (OR 13.316, 95% CI 7.507-23.622, P <0.001) had a significantly higher probability of deteriorating into failure class. The adjusted hazard ratios for 90-day mortality were 1.884 for the risk group, 3.401 for the injury group, and 5.306 for the failure group. Conclusions The prevalence of AKI was high among critically ill patients in Chinese ICUs. In comparison with non-AKI patients, patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F. The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.
基金：
Beijing Municipal Science & Technology Commission (BSTC)Beijing Municipal Science & Technology Commission [101100050010058]
第一作者机构：[1]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China
通讯作者：
通讯机构：[*1]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China[*2]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
推荐引用方式(GB/T 7714)：
Wen Ying,Jiang Li,Xu Yuan,et al.Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units: a prospective cohort study[J].CHINESE MEDICAL JOURNAL.2013,126(23):4409-4416.doi:10.3760/cma.j.issn.0366-6999.20132065.
APA：
Wen Ying,Jiang Li,Xu Yuan,Qian Chuan-yun,Li Shu-sheng...&Du Bin.(2013).Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units: a prospective cohort study.CHINESE MEDICAL JOURNAL,126,(23)
MLA：
Wen Ying,et al."Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units: a prospective cohort study".CHINESE MEDICAL JOURNAL 126..23(2013):4409-4416
