【住院患者隐性肾衰竭与药物处方】。

J M Peña Porta, C V de Vera Floristán, M Bueno Lozano
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引用次数: 8

摘要

目的:估算肾小球滤过率(glomerular filtration rate, GFR)的公式有助于发现“隐性”肾衰竭(hidden renal failure, RF)(血清肌酐正常且GFR < 60 ml/mto/1.73 m2)。本研究的目的是分析这种现象在住院患者中的流行程度,以及这种现象如何影响药物处方。患者和方法:在三个月期间(2006年4月至6月),在barbasstro医院(西班牙韦斯卡)内科住院的567名患者。采用简化的MDRD方程估计GFR。通过逻辑回归分析,我们分析了与“隐藏”射频存在相关的因素。我们还记录了出院时处方的潜在危险药物。结果:隐匿性射频患病率为10.8%。35.2%的患者存在NKF慢性肾脏疾病3.4或5期。与“隐藏”RF存在相关的变量为年龄(expB = 1.035;Ic95% 1.012 - 1.060;p = 0.004)和女性(expB = 4.669;Ic95% 2.461 - 8.856;P < 0.0001)。只有1.8%的病例在住院期间计算了GFR。考虑到肾功能衰竭的程度,相当多的“隐性”射频患者接受了潜在危险药物的治疗。结论:本研究结果支持在实验室报告中引入MDRD方程估算GFR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Hidden renal failure and drug prescription in hospitalized patients].

Objective: Equations used to estimate glomerular filtarion rate (GFR) are useful to detect "hidden" renal failure (RF) ( coexistence of normal serum creatinine together with GFR < 60 ml/mto/1.73 m2 ). The aim of this study was to analyze the prevalence of this phenomenon in hospitalized patients and how this affects drugs prescription.

Patients and method: 567 patients admitted to the internal medicine section of Barbastro Hospital (Huesca, Spain) during a three months period (april-june 2006) were included. GFR was estimated applying abbreviated MDRD equation. By means of logistic regression analysis we analyzed the factors associated with the presence of "hidden" RF. We also recorded the potentially dangerous drugs prescribed at discharge from hospital.

Results: Prevalence of "Hidden" RF was 10.8 %. NKF chronic kidney disease stages 3.4 or 5 were present in 35.2 % of patients. Variables associated with presence of "hidden" RF were age (expB = 1.035; IC95% 1.012 - 1.060; p = 0.004) and female sex (expB = 4.669; IC95% 2.461 - 8.856; p < 0.0001). Only in 1.8 % of cases GFR was calculated during hospitalisation period. A considerable number of patients with "hidden" RF received treatment with potentially dangerous drugs taking into account his degree of renal failure.

Conclusions: Our results support the introduction of GFR estimation by means of MDRD equation in laboratory reports.

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