Lancet：低血压和脱水是急性肾损伤常见原因

2016-04-15 Mechront 译 MedSci原创

急性肾损伤的流行病学数据是稀缺的，尤其是在低收入国家(LICs) 和中下收入国家 (LMICs)。研究者进行了一项研究，评估急性肾损伤的识别、管理和结局的区域差异。在这项跨国的横断面研究中，来自72个国家289个中心的322名医生负责前瞻性数据的收集，包括医院和非医院诊断为继续肾损伤的儿童和成人患者。获取了急性肾损伤开始的症状体征、合并症、急性肾损伤的危险因素和治疗过程的数据等信息，以及透析需求、

急性肾损伤的流行病学数据是稀缺的，尤其是在低收入国家(LICs) 和中下收入国家 (LMICs)。研究者进行了一项研究，评估急性肾损伤的识别、管理和结局的区域差异。

在这项跨国的横断面研究中，来自72个国家289个中心的322名医生负责前瞻性数据的收集，包括医院和非医院诊断为继续肾损伤的儿童和成人患者。获取了急性肾损伤开始的症状体征、合并症、急性肾损伤的危险因素和治疗过程的数据等信息，以及透析需求、肾功能恢复、7天死亡率、出院或死亡相关数据。根据2014人均国民总收入，将国家分为高收入国家（HICs）、中上收入国家（UMICs）、低收入国家和中下收入国家（LLMICs）。

2014年9月29日-12月7日，共识别了4018名患者，其中2337（58%）名患者为社区获得性急性肾损伤，LLMICs有889/1118 (80%)，UMICs有815/1594 (51%)，HICs有663/1241 (51%)(HICs vs UMICs p=0.33; 其余组间比较p<0.0001)。

低血压（1615 [ 40% ]名）和脱水（1536 [ 38% ]名）是急性肾损伤最常见的原因。脱水是LLMICs最常见急性肾损伤的原因(526/1153 [46%] vs 518/1605 [32%](UMICs) vs 492/1260 [39%](HICs))；低血压是HICs最常见急性肾损伤的原因(564/1260 [45%] vs 611/1605 [38%%](UMICs) vs 440/1153 [38%] (LLMICs))。

7日死亡率为423/3855 (11%)，LLMICs最高(129/1076 [12%])，HICs和UMICs分别为125/1230 [10%]和169/1549 [11%]。

无论国家的收入如何，低血压和脱水是急性肾损伤的常见病因，或许可以通过一个标准化的方法对急性肾损伤进行早期诊断与治疗。研究的局限性包括：门诊和LICs患者的比例很小，可能会低估急性肾损伤的真实负担。此外需要提高社区医疗机构对急性肾损伤的认识，尤其是在LICs。

原始出处：

Ravindra L Mehta, Emmanuel A Burdmann, et al.Recognition and management of acute kidney injury in the International Society of Nephrology 0by25 Global Snapshot: a multinational cross-sectional study.Lancet.Published Online: 13 April 2016

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2018-03-15 1e145228m78(暂无匿称)

学习了.谢谢作者分享!

105 0
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2016-09-14 howi

#Lancet#

73 0
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2016-08-18 doctorJiangchao

继续学习

109 0
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createdBy=092f1696875, createdName=Aimily, createdTime=Fri Apr 22 00:59:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367335, encodeId=044a136e335d2, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397002, encodeId=4996139e0021d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-08-18 doctorJiangchao

继续关注

113 0
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-05-10 卡莲

值得学习

166 0
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-04-22 Aimily

临床中需要注意这两个方面

149 0
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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-04-17 chentianping

#低血压#

77 0
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createdBy=3f0227, createdName=howi, createdTime=Wed Sep 14 21:56:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100279, encodeId=8be01002e999, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100280, encodeId=05ce10028063, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85390, encodeId=3c10853908c, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Tue May 10 21:13:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80112, encodeId=503e8011265, content=临床中需要注意这两个方面, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=092f1696875, createdName=Aimily, createdTime=Fri Apr 22 00:59:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367335, encodeId=044a136e335d2, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397002, encodeId=4996139e0021d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78824, encodeId=344fe882445, content=能用血容量不足引起的肾前性因素解释吗？, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 16 22:33:00 CST 2016, time=2016-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78806, encodeId=f9fae8806f2, content=要主意低血压, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-04-17 ms3046638856685384

#损伤#

65 0
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createdBy=3f0227, createdName=howi, createdTime=Wed Sep 14 21:56:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100279, encodeId=8be01002e999, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100280, encodeId=05ce10028063, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85390, encodeId=3c10853908c, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Tue May 10 21:13:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80112, encodeId=503e8011265, content=临床中需要注意这两个方面, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=092f1696875, createdName=Aimily, createdTime=Fri Apr 22 00:59:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367335, encodeId=044a136e335d2, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397002, encodeId=4996139e0021d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78824, encodeId=344fe882445, content=能用血容量不足引起的肾前性因素解释吗？, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 16 22:33:00 CST 2016, time=2016-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78806, encodeId=f9fae8806f2, content=要主意低血压, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-04-16 layyjiangli

能用血容量不足引起的肾前性因素解释吗？

118 0
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createdBy=3f0227, createdName=howi, createdTime=Wed Sep 14 21:56:00 CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100279, encodeId=8be01002e999, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100280, encodeId=05ce10028063, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Aug 18 13:08:00 CST 2016, time=2016-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85390, encodeId=3c10853908c, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=166, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Tue May 10 21:13:00 CST 2016, time=2016-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=80112, encodeId=503e8011265, content=临床中需要注意这两个方面, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=092f1696875, createdName=Aimily, createdTime=Fri Apr 22 00:59:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367335, encodeId=044a136e335d2, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397002, encodeId=4996139e0021d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Apr 17 11:56:00 CST 2016, time=2016-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78824, encodeId=344fe882445, content=能用血容量不足引起的肾前性因素解释吗？, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=00531550470, createdName=layyjiangli, createdTime=Sat Apr 16 22:33:00 CST 2016, time=2016-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78806, encodeId=f9fae8806f2, content=要主意低血压, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0a6a1604604, createdName=Gsurgeon, createdTime=Sat Apr 16 22:04:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
2016-04-16 Gsurgeon

要主意低血压

98 0

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Lancet：低血压和脱水是急性肾损伤常见原因

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