4 0 9 5 7

论文已发表


注册即可获取德孚的最新动态



IF 收录期刊










更多详情 >>



会员计划

我们很高兴为机构提供一种切实的方法以支持开放获取并鼓励教师和研究人员通过开放获取模式尽可能广泛地传播他们的作品。

更多详情 >>

 

加入德孚官方微信,即可享受论文费用7.5折

已发表论文

在无之前已存在的慢性肾病的非常老年患者中的 AKI:使用 KDIGO 标准诊断 AKI 的 48 小时窗口和 7 天窗口比较

 

Authors Li Q, Zhao M, Wang X

Received 17 January 2018

Accepted for publication 22 March 2018

Published 20 June 2018 Volume 2018:13 Pages 1151—1160

DOI https://doi.org/10.2147/CIA.S162899

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Dr Wu

Objectives: To compare the differences between the Kidney Disease Improving Global Outcomes (KDIGO) criteria of the 48-hour window and the 7-day window in the diagnosis of acute kidney injury (AKI) in very elderly patients, as well as the relationship between the 48-hour and 7-day windows for diagnosis and 90-day mortality.
Patients and methods: We retrospectively enrolled very elderly patients (≥75 years old) from the geriatrics department of the Chinese PLA General Hospital between January 2007 and December 2015. AKI patients were divided into 48-hour and 7-day groups by their diagnosis criteria. AKI patients were divided into survivor and nonsurvivor groups by their outcomes within 90 days after diagnosis of AKI.
Results: In total, 652 patients were included in the final analysis. The median age of the cohort was 87 (84–91) years, the majority (623, 95.6%) of whom were male. Of the 652 AKI patients, 334 cases (51.2%) were diagnosed with AKI by the 48-hour window for diagnosis, while 318 cases (48.8%) were by the 7-day window for diagnosis. The 90-day mortality was 42.5% in patients with 48-hour window AKI and 24.2% in patients with 7-day window AKI. Kaplan–Meier curves showed that 90-day mortality was lower in the 7-day window AKI group than in the 48-hour window AKI group (log rank: <0.001). Multivariate analysis by the Cox model revealed that 48-hour window for diagnosis hazard ratio (HR=1.818; 95% CI: 1.256–2.631; =0.002) was associated with higher 90-day mortality.
Conclusion: The 90-day mortality was higher in 48-hour window AKI than in 7-day window AKI in very elderly patients. The 48-hour KDIGO window definition may be less sensitive. The 48-hour KDIGO window definition is significantly better correlated with subsequent mortality and is, therefore, still appropriate for clinical use. Finding early, sensitive biomarkers of kidney damage is a future direction of research.
Keywords: acute kidney injury, AKI diagnosis time, very elderly, short-term mortality




Figure 1 Flow chart of patient inclusion and exclusion.