Risk Factors for AKI课件.pptVIP

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Risk Factors for AKI课件.ppt

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Risk Factors for AKI Dr It?r Ye?ana?a KOU T?p Fakültesi Incidence of ARF: 1%-25%; depends on the definition Mortality of ARF: 28%-90% Schaefer JH…Intensive Care Med 1991, 17:19-24 Brivet FG… Crit Care Med 1996, 24:192-198 Baldaya AP… Am J Kidney Dis 1996, 28 (suppl):s81-89 De Mendoca A… Intensive Care Med 2000, 26:915-921 E Hoste..Crit Care Med 2008,36suppl4:146-151 In the community setting; 17 per milion per year age 50, 620 per milion per year age age 80-89 1% hospital admission in the USA Hospital aquired AKI 5-7% Community aquired less then X 5-10 R Pisoni..Nephron Clin Practice 2008,109:188-191 Hospital-aquired ARF University hospitals in the USA (2002) Incidence of ARF: 7.2% Overall Mortality:19.4%, Required Dialysis 2.7% Regain normal RF:38.6% Higher serum creatinine, older age, sepsis risk for higher mortality Pre-exist. of CKD threefold risk for ARF Nash K… Am J Kidney Dis 2002,39:930-936 Medicare Analysis ARF increases 11% per year 1979-2001 Mort. Decreases 38.8% to 32.2% Required Dialysis mort. 45.7% to 44.6% Risk factor: Older age, male gender, black race.. Secondary ARF; having sepsis, ICU stay, other organ dysfunction CA Block… The Epidemiology and outcome of acute renal failure and the impact on chronic kidney disease Semianars in Dialysis 2006,19:6,450-454 Brivet study (prospective, multicenter)(French Study Group on Acute Renal Failure)Crit Care Med 1996,24:2,192-198 360 patients, (in 20 ICU) Age,(OR:1.55;1.32-1.81) previous health status,(2.35;1.37-4.07) Severity of illness(SAPS) (1.54;1.36-1.75) disease characteristics; initial or delayed ARF, oliguria,(2.22;1.28-3.84) sepsis(48%)(higher mort.rate 73%/45%) (2.32;1.37-3.93) ARF in Critically Ill PICARD study-618 patients (1999-2001) with ARF in USA (5 academic center) overall mortality 37% non-recovery of renal function 50% ARF on CKD mort.lower (31%/41%) Mort. increases in relation of the number of organ