https://scholars.lib.ntu.edu.tw/handle/123456789/588478
標題: | Long-term risk of upper gastrointestinal hemorrhage after advanced AKI | 作者: | Wu P.-C. Wu C.-J. Lin C.-J. VIN-CENT WU |
公開日期: | 2015 | 出版社: | American Society of Nephrology | 卷: | 10 | 期: | 3 | 起(迄)頁: | 353-362 | 來源出版物: | Clinical Journal of the American Society of Nephrology | 摘要: | Background and objectives There are few reports on temporary dialysis-requiring AKI as a risk factor for future upper gastrointestinal bleeding (UGIB). This study sought to explore the long-termassociation between dialysisrequiring AKI and UGIB. Design, setting, participants, &measurements This nationwide cohort study used data fromthe Taiwan National Health Insurance Research Database. Patients who recovered from dialysis-requiring AKI and matched controls were selected from hospitalized patients age $18 years between 1998 and 2006. The cumulative incidences of long-term de novo UGIB were calculated, and the risk factors of UGIB and mortality were identified using timevarying Cox proportional hazard models adjusted for subsequent CKD and ESRD after AKI. Results A total of 4565 AKI-recovery patients and the same number of matched patients without AKI were analyzed. After amedian follow-up time of 2.33 years (interquartile range, 0.97–4.81 years), the incidence rates of UGIB were 50 (by stringent criterion) and 69 (by lenient criterion) per 1000 patient-years in the AKI-recovery group and 31 (by stringent criterion) and 48 (by lenient criterion) per 1000 patient-years in the non-AKI group (both P,0.001). When compared with patients in the non-AKI group, the multivariate hazard ratio (HR) for UGIB was 1.30 (95% confidence interval [95% CI], 1.14 to 1.48) for dialysis-requiring AKI, 1.83 (95% CI, 1.53 to 2.20) for time-varying CKD, and 2.31 (95% CI, 1.92 to 2.79) for time-varying ESRD (all P,0.001). Finally, the risk for long-term mortality increased after UGIB (HR, 1.24; 95% CI, 1.12 to 1.38) and dialysis-requiring AKI (HR, 1.66; 95% CI, 1.54 to 1.78). Conclusions Recovery from dialysis-requiring AKI was associated with future UGIB and mortality. ? 2015 by the American Society of Nephrology. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84924407149&doi=10.2215%2fCJN.01240214&partnerID=40&md5=1fb47d423201eea0346df09582c92b70 https://scholars.lib.ntu.edu.tw/handle/123456789/588478 |
ISSN: | 1555-9041 | DOI: | 10.2215/CJN.01240214 | SDG/關鍵字: | acetylsalicylic acid; amoxicillin; clarithromycin; clopidogrel; corticosteroid; heparin; histamine H2 receptor antagonist; low molecular weight heparin; metronidazole; nonsteroid antiinflammatory agent; proton pump inhibitor; tetracycline; warfarin; acute kidney failure; adult; Article; chronic kidney disease; comorbidity; controlled study; end stage renal disease; female; follow up; Helicobacter infection; hemodialysis; human; major clinical study; male; middle aged; mortality; risk factor; treatment outcome; upper gastrointestinal bleeding; Acute Kidney Injury; aged; case control study; complication; gastrointestinal hemorrhage; hemodialysis; incidence; Kidney Failure, Chronic; proportional hazards model; retrospective study; risk factor; statistics and numerical data; Taiwan; time factor; very elderly; Acute Kidney Injury; Aged; Aged, 80 and over; Case-Control Studies; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Incidence; Kidney Failure, Chronic; Male; Middle Aged; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Risk Factors; Taiwan; Time Factors |
顯示於: | 醫學系 |
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