【两分钟医学英语】急性肾损伤（AKI）与重症患儿死亡率的关系（AWARE试验）

AKI associated with increased mortality among critically ill children and young adults: The AWARE trial

1. The study demonstrated that acute kidney injury (AKI) is common in critically ill children and young adults, and is associated with increased mortality.

2. The majority of patients meeting the definition of AKI were missed when only the plasma creatinine criteria was used to make a diagnosis.

Evidence Rating: 2 (Good)

In adults, AKI is associated with prolonged mechanical ventilation, longer length of stay in the ICU, and increased mortality in critically ill patients. However, studies in children are limited. The Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology (AWARE) study was conducted to define the epidemiology of AKI and the risk factors AKI and associated morbidity in a multinational cohort of critically ill children and young adults. The primary outcome was 28-day mortality. Secondary outcomes were length of stay in the ICU, receipt and duration of mechanical ventilation, receipt of extracorporeal membrane oxygenation, and receipt of renal-replacement therapy. The study demonstrated that AKI occurred in 25% of patients during the first 7 days after ICU admission. A significantly higher risk of death was observed in patients with severe AKI. There was significantly higher 28-day mortality in patients with the most severe AKI. For the majority of patients with an AKI diagnosis meeting the low urine-output criteria, the diagnosis would have been missed if only the plasma creatinine criteria had been used.

来源：新英格兰医学杂志（N Engl J Med 2017; 376:11-20January 5, 2017DOI: 10.1056/NEJMoa1611391）

https://www.nejm.org/doi/full/10.1056/NEJMoa1611391