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已发表论文
早期识别和风险因素用于急性肾损伤进展：一项真实世界研究
Authors Nan Z, Fan X, Guo S, Zhao CC, Yang J, Wang Y, Zhang T
Received 26 October 2025
Accepted for publication 26 January 2026
Published 2 February 2026 Volume 2026:19 576846
DOI https://doi.org/10.2147/RMHP.S576846
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Mecit Can Emre Simsekler
Zihan Nan,1,* Xiaoxuan Fan,1,* Shaohan Guo,1 Cong-Cong Zhao,1 Jiangtao Yang,1 Yingxin Wang,2 Tao Zhang1
1Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tao Zhang, Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China, Tel +86 0311 5482, Email zhangtao@hebmu.edu.cn
Purpose: Acute kidney injury (AKI) is a serious complication in critically ill patients, associated with increased mortality and healthcare burden. Early identification of patients at high risk for disease progression is crucial for timely intervention and improved outcomes. To identify the risk factors for the progression of AKI in critically ill patients.
Patients and Methods: A single-center, retrospective study was conducted involving 341 adult patients diagnosed with AKI stage 1 or 2 according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for AKI progression. Subgroup analyses were performed based on the initial AKI stage.
Results: Among the 341 enrolled patients, 156 (45.7%) experienced AKI progression. Multivariate analysis identified the following independent risk factors: ischemic heart disease (adjusted Odds Ratio [aOR] = 2.994), sepsis (aOR = 2.644), lower minimum Mean Arterial Pressure (MAP) (aOR = 0.954), higher neutrophil percentage (aOR = 1.029), lower PaO2/FiO2 ratio (aOR = 0.997), elevated D-dimer (aOR = 1.097), and increased anion gap (aOR = 1.163). Subgroup analysis revealed that risk factors differed between patients with initial AKI stage 1 and stage 2.
Conclusion: This study identified multiple routinely available clinical factors independently associated with AKI progression. These findings support early risk stratification and targeted interventions—such as infection control, hemodynamic support, and correction of hypoxia and acidosis—to prevent the worsening of AKI and improve patient outcomes.
Keywords: acute kidney injury, disease progression, risk factors, critical illness, logistic models, retrospective studies
1Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China; 2Department of Critical Care Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Tao Zhang, Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China, Tel +86 0311 5482, Email zhangtao@hebmu.edu.cn
Purpose: Acute kidney injury (AKI) is a serious complication in critically ill patients, associated with increased mortality and healthcare burden. Early identification of patients at high risk for disease progression is crucial for timely intervention and improved outcomes. To identify the risk factors for the progression of AKI in critically ill patients.
Patients and Methods: A single-center, retrospective study was conducted involving 341 adult patients diagnosed with AKI stage 1 or 2 according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for AKI progression. Subgroup analyses were performed based on the initial AKI stage.
Results: Among the 341 enrolled patients, 156 (45.7%) experienced AKI progression. Multivariate analysis identified the following independent risk factors: ischemic heart disease (adjusted Odds Ratio [aOR] = 2.994), sepsis (aOR = 2.644), lower minimum Mean Arterial Pressure (MAP) (aOR = 0.954), higher neutrophil percentage (aOR = 1.029), lower PaO2/FiO2 ratio (aOR = 0.997), elevated D-dimer (aOR = 1.097), and increased anion gap (aOR = 1.163). Subgroup analysis revealed that risk factors differed between patients with initial AKI stage 1 and stage 2.
Conclusion: This study identified multiple routinely available clinical factors independently associated with AKI progression. These findings support early risk stratification and targeted interventions—such as infection control, hemodynamic support, and correction of hypoxia and acidosis—to prevent the worsening of AKI and improve patient outcomes.
Keywords: acute kidney injury, disease progression, risk factors, critical illness, logistic models, retrospective studies