Incidence, risk factors, and clinical outcomes of acute kidney injury associated with acute pyelonephritis in patients attending a tertiary care referral center

被引:7
|
作者
Jeon, Dae-Hong [1 ,3 ]
Jang, Ha Nee [1 ]
Cho, Hyun Seop [1 ]
Lee, Tae Won [2 ]
Bae, Eunjin [2 ,3 ]
Chang, Se-Ho [1 ,3 ,4 ]
Park, Dong Jun [2 ,3 ,4 ]
机构
[1] Gyeongsang Natl Univ Hosp, Dept Internal Med, Jinju, South Korea
[2] Changwon Gyeongsang Natl Univ Hosp, Dept Internal Med, Chang Won 51472, South Korea
[3] Gyeongsang Natl Univ, Dept Internal Med, Coll Med, Jinju, South Korea
[4] Gyeongsang Natl Univ, Inst Hlth Sci, Jinju, South Korea
关键词
Acute kidney injury; pyelonephritis; risk factor; ACUTE-RENAL-FAILURE; UNIT; DIAGNOSIS; MORTALITY; DIALYSIS; SEPSIS; CKD;
D O I
10.1080/0886022X.2019.1591995
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Acute kidney injury (AKI) associated with acute pyelonephritis (APN) rarely has been reported. The aim of this study was to evaluate the incidence and risk factors of AKI associated with APN. We retrospectively reviewed the medical records of 403 patients over 18-year old age hospitalized for APN management from October 2009 to September 2014 in tertiary care referral center. Demographic data, clinical symptoms and signs, and laboratory findings were gathered from the medical records and analyzed. The mean age of patients was 57 years and APN commonly occurred in female (87.6%). AKI occurred in 253 patients (62.8%). As per the RIFLE classification, renal injury was graded as 'Risk' (62.1%), 'Injury' (26.5%), and 'Failure' (11.4%). AKI patients were more likely a male gender and had complicated APN. The AKI group had a significantly higher tendency to present with shock. The prevalence of underlying chronic kidney disease (CKD) was significantly higher in the AKI group. There was no difference in mortality between the AKI and non-AKI groups. Multivariate analysis revealed that age over 65 (OR 1.93, 95% CI 1.18-3.13, p= .008), complicated (OR 2.13, 95% CI 1.35-3.34, p= .001) and bilateral APN (OR 1.71, 95% CI 1.01-2.88, p= .045), and initial shock (OR 2.44, 95% CI 1.05-5.71, p= .039) were independent risk factors for the occurrence of AKI in patients with APN. Physicians should attempt to prevent, detect, and manage AKI associated with APN in patients with above conditions.
引用
收藏
页码:204 / 210
页数:7
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