在急性肝衰竭或急性肝损伤后,对功能进行长期跟踪:一个队列研究
Pedro Fidalgo1, Pedro Póvoa1,2, Nuno Germano3
1Polyvalent Intensive Care Unit, São Francisco Xavier Hospital, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
GE Portuguese journal of gastroenterology
|October 3, 2024
概括
在急性肝衰竭 (ALF) 或急性肝损伤 (ALI) 幸存者的急性损伤 (AKI) 并没有显著影响长期功能. 这项研究发现,在ICU入院后一年的幸存者中,早期AKI和降低的eGFR之间没有关联.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
背景情况:
- 急性肝衰竭 (ALF) 是一种严重的疾病,死亡率高.
- 急性损伤 (AKI) 经常使ALF和急性肝损伤 (ALI) 复杂化.
- 了解这些患者AKI对脏的长期后果对于预后至关重要.
研究的目的:
- 评估AKI对ALF或ALI幸存者的长期功能的影响.
- 为了确定在重症监护室 (ICU) 停留期间的AKI是否与入院后至少一年的估计球过率 (eGFR) 降低有关.
主要方法:
- 一项观察性队列研究包括了进入第三级重症监护室的ALF或ALI的成年患者.
- 使用KDIGO标准定义了AKI和慢性病 (CKD).
- 主要结局是ICU入院后至少一年的eGFR,使用CKD-EPI公式计算.
主要成果:
- 在ICU前7天的AKI与增加的住院死亡率有关.
- 在具有可用的长期功能数据 (n=56) 的住院幸存者中,在 >1年的随访期 (p=0.15) 中,AKI与eGFR没有显著的关联.
- 五名患者在入院后至少一年患有CKD,没有病例需要脏替代疗法 (RRT).
结论:
- 在ALF或ALI的幸存者中,AKI与显著的长期功能下降无关.
- 在这个队列中,早期的AKI没有预测ICU退院后一年降低eGFR.
- 进一步的研究可能会探索特定的AKI表型及其长期结局.
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