CAJ | 학술논문

目的分析2012年国际改善全球肾脏病预后组织（KDIGO）发表的急性肾损伤（AKI）和急性肾脏病（ AKD）定义在不同类型的新月体肾炎中的应用。方法2009年1月至2012年12月在北京大学第一医院肾内科住院接受肾活检其光镜病理检查超过50％肾小球内有新月体形成的患者。根据2012年KDIGO指南AKI/AKD的定义，以血肌酐（Scr）和24 h尿量为指标将入选的患者分为AKI组，非AKI的AKD组，非AKD组和无法分类组。结果 AKD能够识别84.2％的新月体肾炎患者，而AKI仅能识别61.4％的患者。对于不同类型的新月体肾炎，AKI识别抗GBM抗体型最高，达91％。新月体性肾小球肾炎较肾小球肾炎伴多数新月体形成更易被AKI识别（ P＝0.002）。不同成分为主的新月体肾炎， AKI/AKD的识别无统计学差异。结论2012年KDIGO AKD的定义比AKI更能够早期识别急性肾功能不全的患者。
목적분석2012년국제개선전구신장병예후조직（KDIGO）발표적급성신손상（AKI）화급성신장병（ AKD）정의재불동류형적신월체신염중적응용。방법2009년1월지2012년12월재북경대학제일의원신내과주원접수신활검기광경병리검사초과50％신소구내유신월체형성적환자。근거2012년KDIGO지남AKI/AKD적정의，이혈기항（Scr）화24 h뇨량위지표장입선적환자분위AKI조，비AKI적AKD조，비AKD조화무법분류조。결과 AKD능구식별84.2％적신월체신염환자，이AKI부능식별61.4％적환자。대우불동류형적신월체신염，AKI식별항GBM항체형최고，체91％。신월체성신소구신염교신소구신염반다수신월체형성경역피AKI식별（ P＝0.002）。불동성분위주적신월체신염， AKI/AKD적식별무통계학차이。결론2012년KDIGO AKD적정의비AKI경능구조기식별급성신공능불전적환자。
Objective To validate whether 2012 KDIGO definitions of AKI and AKD were applicable for patients with crescent glomerulonephritis .Methods Patients who were pathologically defined as ≥50% of the glomeruli having crescents between 1 January 2009 and 31 December 2012 were enrolled in the study .2012 KDIGO AKD and AKI definition were applied to identify patients with AKI , AKD without AKI , non-AKD and unclassified group according to the changes of serum creatinine ( Scr ) and urine volume throughout the disease course . Results The AKD definition could recognize 84.2% of the patients with crescent glomerulonephritis , while AKI could only identify 61.4% of such patients .For different types of crescent glomerulonephritis , anti-GBM type was recognized by AKI at best ( 91%) .AKI could identify crescentic glomerulonephritis better than glomerulonephritis with majority crescents formation ( P=0.002 ) .There was no statistically significance between different composition of crescent,irrespectively of AKI/AKD criterion.Conclusions The KDIGO AKD definition can detect patients with renal dysfunction of crescent glomerulonephritis earlier than AKI .