中国急性肾损伤:一项横断面调查

Acute kidney injury in China: a cross-sectional survey
2015-10-30 09:50发表评论
作者:Yang, L. , Xing, G., Wang, L., Wu, Y., Li, S., Xu, G., He, Q., Chen, J., Chen, M., Liu, X., Zhu, Z., Yang, L., Lian, X., Ding, F., Li, Y., Wang, H., Wang, J., Wang, R., Mei, C., Xu, J., Li, R., Cao, J., Zhang, L., Wang, Y., Xu, J., Bao, B., Liu, B., Chen, H., Li, S., Zha, Y., Luo, Q., Chen, D., Shen, Y., Liao, Y., Zhang, Z., Wang, X., Zhang, K., Liu, L., Mao, P., Guo, C.
机构: 北京大学第一医院
期刊: Lancet2015年10月10002期366卷

Background Acute kidney injury (AKI) has become a worldwide public health problem, but little information is available about the disease burden in China. We aimed to evaluate the burden of AKI and assess the availability of diagnosis and treatment in China. Methods We launched a nationwide, cross-sectional survey of adult patients who were admitted to hospital in 2013 in academic or local hospitals from 22 provinces in mainland China. Patients with suspected AKI were screened out on the basis of changes in serum creatinine by the Laboratory Information System, and we reviewed medical records for 2 months (January and July) to confirm diagnoses. We assessed rates of AKI according to two identification criteria: the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) AKI definition and an increase or decrease in serum creatinine by 50% during hospital stay (expanded criteria). We estimated national rates with data from the 2013 report by the Chinese National Health and Family Planning Commission and National Bureau of Statistics. Findings Of 2 223 230 patients admitted to the 44 hospitals screened in 2013, 154 950 (7·0%) were suspected of having AKI by electronic screening, of whom 26 086 patients (from 374 286 total admissions) were reviewed with medical records to confirm the diagnosis of AKI. The detection rate of AKI was 0·99% (3687 of 374 286) by KDIGO criteria and 2·03% (7604 of 374 286) by expanded criteria, from which we estimate that 1·4-2·9 million people with AKI were admitted to hospital in China in 2013. The non-recognition rate of AKI was 74·2% (5608 of 7555 with available data). Renal referral was done in 21·4% (1625 of 7604) of the AKI cases, and renal replacement therapy was done in 59·3% (531 of 896) of those who had the indications. Delayed AKI recognition was an independent risk factor for in-hospital mortality, and renal referral was an independent protective factor for AKI under-recognition and mortality Interpretation AKI has become a huge medical burden in China, with substantial underdiagnosis and undertreatment. Nephrologists should take the responsibility for leading the battle against AKI. © 2015 Elsevier Ltd.

 

通讯机构:Peking University First Hospital, Beijing, China
学科代码:内科学   关键词:中国急性肾损伤 ,中国作者重要发表 爱思唯尔医学网, Elseviermed
来源: 《门诊》杂志
《门诊》杂志介绍:《门诊》杂志创刊于2009年夏,是以心血管临床最新动态为主要传播内容、现代传播学为基本理念的医学类杂志,其宗旨是及时反映心血管领域的临床新技术、新成就、新进展,由上海东闻文化传媒有限公司独立运营。临床学术跟踪是国际高端医学媒体应用的信息开发概念,它能帮助媒体及时掌握最新的临床动态。《门诊》杂志在中国第一次建立了初步的临床学术跟踪体系,全面跟踪并报道医师的最新观点,最新临床进展,最新病例,最新科研成果及数据分析。 马上访问《门诊》杂志网站www.menzhen.org
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