Risk factors for the progression of chronic kidney disease after acute kidney injury

Abstract Introduction: The incidence of chronic kidney disease (CKD) is increasing with the increasing age of the population and the increasing number of elderly survivors of acute kidney injury (AKI). The risk factors for the progression of CKD after AKI are unclear. Objective: To investigate the association between AKI and its progression to CKD and the risk factors involved. Methods: An observational, retrospective study of AKI patients followed from 2009 to 2012 was carried out. We evaluated the etiology of AKI, the use of vasoactive drugs and mechanical ventilation, the need for dialysis, the presence of comorbidities, the glomerular filtration rate (GFR), the length of stay and the progression of CKD. Statistical analyses, including the Chi-square test and Pearson's correlation, were performed using SPSS. Results: The 207 patients analyzed had a mean age of 70.1 ± 13.1, and 84.6% of the male patients exhibited decreased renal function and CKD (vs. 60.4% of the female patients). The progression of AKI to CKD was more frequent in patients admitted to wards (63.8%), cancer patients (74.19%), patients with sepsis (67.18%) and patients with obstruction (91.66%). Dialyses were performed in 16.4% of the patients, but this was not correlated with the progression of CKD. Conclusions: Being an elderly male patient with AKI due to sepsis and obstruction was correlated with progression to CKD following discharge.

摘要引言：随着人口老龄化进程加快以及急性肾损伤（acute kidney injury, AKI）老年幸存者人数增加，慢性肾脏病（chronic kidney disease, CKD）的发病率逐年攀升。目前AKI患者后续进展为CKD的危险因素尚未明确。研究目的：探讨AKI与其进展为CKD的相关性及相关危险因素。研究方法：本研究为观察性回顾性研究，纳入2009年至2012年随访的AKI患者。研究评估了AKI的病因、血管活性药物使用情况、机械通气指征、透析需求、合并症情况、肾小球滤过率（glomerular filtration rate, GFR）、住院时长以及CKD进展情况。采用SPSS软件开展卡方检验、Pearson相关分析等统计学分析。研究结果：共纳入207例患者，平均年龄为70.1±13.1岁；其中84.6%的男性患者出现肾功能下降及CKD，女性患者占比为60.4%。AKI进展为CKD的情况在普通病房收治患者（63.8%）、恶性肿瘤患者（74.19%）、脓毒症患者（67.18%）以及梗阻患者（91.66%）中更为多见。16.4%的患者接受了透析治疗，但透析与CKD进展无显著相关性。研究结论：老年男性AKI患者，因脓毒症或梗阻致病者，出院后进展为CKD的风险显著升高。