Acute Kidney Injury Associates with Increased Long-Term Mortality Acute Kidney Injury Associates with Increased Long-Term Mortality 急性肾损伤与增加长期死亡率的关联性 Journal of the American Society of Nephrology,Vol.0021,Issue 002,Page 345 美国肾病学会杂志 Acute kidney injury (AKI) associates with higher in-hospital mortality, but whether it also associates with increased long-term mortality is unknown, particularly after accounting for residual kidney function after hospital discharge. 急性肾损伤（AKI）具有较高的住院死亡率，但它是否增加长期的死亡率是未知的，尤其是在出院后残余肾功能的相关性。 We retrospectively analyzed data from US veteran patients who survived at least 90d after discharge from a hospitalization. We identified AKI events not requiring dialysis from laboratory data and classified them according to the ratio of the highest creatinine during the hospitalization to the lowest creatinine measured between 90 d before hospitalization and the date of discharge. 我们回顾性分析美国退伍军人中出院后存活至少90天的患者数据。我们确定了AKI的事件根据以下
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分类:住院期间肌酐最高到最低的比率、出院后90天测量到的肌酐水平。 We estimated mortality risks using multivariable Cox regression models adjusting for demographics, comorbidities,medication use, primary diagnosis of admission, length of stay, mechanical ventilation, and postdischarge estimated GFR (residual kidney function). Among the 864,933 hospitalized patients in the study cohort, we identified 82,711 hospitalizations of patients with AKI. 我们估计死亡风险采用多变量Cox回归模型，用于人数统计、合并症、用药、入院原发病诊断、住院时间、机械通气时间，和评估出院后GFR（残余肾功能）。在864933住院病人中，我们确定了82711例AKI住院患者为研究对象。 In the study population of patients who survived at least 90 d after discharge, 17.4% died during follow-up (AKI 29.8%, without AKI 16.1%). The adjusted mortality risk associated with AKI was 1.41 (95% confidence interval [CI] 1.39 to 1.43) and increased with increasing AKI stage: 1.36 (95% CI 1.34 to 1.38), 1.46 (95% CI 1.42 to 1.50), and 1.59 (95% CI 1.54 to 1.65; P <0.001 for trend). 在出院后存活至少90天的研究人群中，17.4％死于随访期间（AKI的29.8％，无AKI的16.1％）。调整后的AKI相关的死亡风险为1.41（95％置信区间[CI]为1.39至1.43），并随AKI的阶段增加：1.36（95％CI为1.34-1.38），1.46（95％CI为1.42-1.50）和1.59 （95％CI为1.54-1.65; P值<0.001）。 In conclusion, AKI that does not require dialysis associates with increased long-term mortality risk, independent of residual kidney function, for patients who survive 90 d after discharge. Long-term mortality risk is highest among the most severe cases of AKI. 结果显示，出院后生存90天以上，不需要透析的AKI患者当中，AKI与增加长期死亡率风险相关，不依赖于患者残余肾功能。AKI的重症病例长期死亡风险最高。
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