急性肾损伤患者的流行病学特征研究现状

谢静宜.急性肾损伤患者的流行病学特征研究现状[J].内科急危重症杂志,2025,31(4):304-310

DOI：10.11768/nkjwzzzz20250403

英文关键词:

基金项目:湖北省自然科学基金（2023AFB838）

作者	单位	E-mail
谢静宜	华中科技大学同济医学院附属同济医院	geshuwang@tjh.tjmu.edu.cn

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中文摘要:

摘要目的：了解急性肾损伤（AKI）的流行病学特征。方法：回顾性分析确诊AKI患者的病历20 659份，收集人口学资料、合并症和实验室检查结果等。结果：住院患者AKI发生率为3.4%，冬季发生率高于夏季，且多发生于男性和中老年人群。传统手术科室的AKI发生例数（9 947例）多于非手术科室（8 238例），心血管外科的AKI发生率（26.72%）接近ICU（27.92%）。符合改善全球肾脏病预后组织（KDIGO）标准定义的AKI病例中，仅有5.7%被确诊，漏诊率高。高分期和ICU的AKI患者多合并有高血压、糖尿病和肺炎等，出现贫血、肝功能下降和高钾血症等电解质紊乱的比例也更高。≥80岁的老年人死亡率高（男性5.16%，女性4.15%）。结论：AKI在冬季和中老年男性中高发，在不同科室的分布存在差异，易漏诊，老年人死亡率高，应增强对高风险人群的监测和早期干预。

英文摘要:

Abstract Objective: To characterize the epidemiology of acute kidney injury (AKI). Methods: We retrospectively analyzed 20,659 medical records of patients diagnosed with AKI, and collected demographic data, comorbidities and laboratory findings. Results: The incidence of AKI in hospitalized patients was 3.4%, with a higher incidence in winter than in summer, and AKI occurred more often in men and middle-aged and elderly people. There were more cases of AKI in traditional surgical units (9947 cases) than in non-surgical units (8238 cases), and the incidence of AKI in cardiovascular surgery (26.72%) was close to that in ICU (27.92%). Only 5.7% of AKI cases meeting the Kidney Disease Improvement Global Prognosis Organization (KDIGO) standard definition were diagnosed, with a high rate of underdiagnosis. Highly staged and ICU patients with AKI were more likely to have comorbidities such as hypertension, diabetes mellitus, and pneumonia, and had higher rates of electrolyte disorders such as anemia, decreased liver function, and hyperkalemia. The mortality rate was higher in >80 years old (5.16% in men and 4.15% in women). Conclusion: AKI is highly prevalent in winter and among middle-aged and elderly males, the distribution of AKI varies in different departments, it is easy to miss the diagnosis, and the mortality rate is high in the elderly, so the monitoring and early intervention of high-risk groups should be strengthened.