关键词: 急性肾损伤, 心脏手术, 生存, 慢性肾脏病, 危险因素

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To evaluate the longterm outcomes of patients with cardiac surgery associated acute kidney injury (CSAAKI).
Ｍｅｔｈｏｄｏｌｏｇｙ：One thousand three hundred and sixty three cardiac surgery patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2012 to December 2013 were enrolled in this study. The patients were divided into the AKI (n=457) and nonAKI groups  (n=906）  according to whether developing CSAAKI and followed up for average 3 years. We recorded the longterm survival rate and the incidence of chronic kidney disease (eGFR<60 ml·min-1·173m2) and analyzed the related factors.
Ｒｅｓｕｌｔｓ：The incidence of CSAAKI was 335% in all the patients with cardiac surgery. The 3year survival rate in the AKI group was lower than that of the nonAKI group (888% vs 972%; P<0001). CSAAKI increased the risk of mortality with the hazard ratio of 262 (95％CI=153～450). Cox regression analysis showed that AKI was an independent risk factor of mortality adjusted of other factors. The incidence of CKD stages 3～5 in the AKI group was higher than that of the nonAKI group (99% vs 23%; P<0001). AKI increased the risk of CKD stages 3～5 with the hazard ratio of 310 (95％CI=175～548). Cox regression analysis showed that AKl was an independent risk factor of CKD stages 3-5 adjusted of other factors. In addition, elder age and lower baseline eGFR were also associated with the risk of CKD stages 3-5.
Ｃｏｎｃｌｕｓｉｏｎ：
CSAAKI increased the risk of 3year mortality and incidence of CKD stages 3～5. More attention should be paid to the prevention and treatment of CSAAKI, and long time followup of the kidney function is needed.

Key words: acute kidney injury, cardiac surgery, survival, chronic kidney disease, risk factors