Long-term risks of adverse kidney outcomes after acute kidney injury: a systematic review and meta-analysis.

Hence, we systematically reviewed the literature to explore differences in kidney dysfunction risks between AKI stages, AKI durations, and clinical settings.

因此，我们系统地回顾了文献，以探讨AKI分期、AKI持续时间以及临床环境之间肾功能障碍风险的差异。

Methods

We performed a systematic search in PubMed and Embase to identify studies that examined at least one outcome of interest in individuals with AKI versus without AKI, with a minimum follow-up of one year.

我们在PubMed和Embase进行了系统检索，以确定研究对象为急性肾损伤（AKI）患者与非AKI患者，至少随访一年，考察至少一个感兴趣的结果。

Hazard/odds ratios (HR/OR) were pooled using random effects models.

使用随机效应模型汇总了危险/比值比（HR/OR）。

Heterogeneity across patient and disease characteristics was examined using subgroup and meta-regression analyses.

使用亚组和元回归分析检查了患者和疾病特征的异质性。

Results

We searched 70 studies, encompassing 1 838 668 individuals, including 165 715 with AKI.

我们检索了70项研究，涵盖了1,838,668名个体，其中包括165,715名急性肾损伤（AKI）患者。

All studies were of moderate to high quality.

所有研究的质量为中等到高。

Individuals with AKI had higher risks of CKD incidence[AKI 25.8%/no AKI 8.7%; HR 2.36 [95% confidence interval(CI) 1.77-2.94)]], CKD progression [AKI 43.1%/no AKI 35.6%; HR 1.83 (95%CI 1.26-2.40)], KF [AKI 2.9%/no AKI 0.5%; HR 2.64 (95%CI 2.03-3.25)], and MAKE [AKI 59.0%/no AKI 32.7%; OR 2.77 (95%CI 2.01-3.53)].

患有急性肾损伤（AKI）的个体发生慢性肾脏病（CKD）的风险更高[AKI 25.8%/无AKI 8.7%; 风险比（HR）2.36 [95% 置信区间（CI）1.77-2.94]]，CKD进展的风险更高[AKI 43.1%/无AKI 35.6%; HR 1.83 (95%CI 1.26-2.40)]，肾功能衰竭（KF）的风险更高[AKI 2.9%/无AKI 0.5%; HR 2.64 (95%CI 2.03-3.25)]，以及主要不良肾脏事件（MAKE）的风险更高[AKI 59.0%/无AKI 32.7%; 比值比（OR）2.77 (95%CI 2.01-3.53)]。

The pooled effect estimates for CKD incidenceafter AKI lasting <3 days remained significant [OR 2.37 (95%CI 1.68-3.07)], even in individuals with AKI stage 1 only [HR 1.49 (95%CI 1.44-1.55)].

即使在仅患有 AKI 1 期的个体中，AKI 持续时间小于3天后 CKD 发病率的汇总效应估计值仍然显著 [OR 2.37 (95%CI 1.68-3.07)]，甚至在仅患有 AKI 1 期的个体中 [HR 1.49 (95%CI 1.44-1.55)]。

Diabetes mellitus, hypertension, requiring acute dialysis, cardiovascular surgery, or coronary artery disease were associated with higher CKD incidenceor progression risks.

糖尿病、高血压、需要急性透析、心血管手术或冠状动脉疾病与较高的 CKD 发病率或进展风险相关。

Conclusions

Risks for kidney dysfunction were higher for all individuals with AKI.

所有急性肾损伤（AKI）患者发生肾功能障碍的风险均较高。

Risk estimates were heterogeneous between patient subgroups, based on AKI stage, AKI duration, and clinical setting, yet even individuals with the lowest stage or shortest duration of AKI remained at higher risk for CKD incidenceor progression.

根据AKI分期、AKI持续时间和临床环境，患者亚组之间的风险估计存在异质性，但即使是AKI分期最低或持续时间最短的个体，其慢性肾脏病（CKD）发生或进展的风险仍然较高。

This highlights the need to develop tailored follow-up strategies to recognize kidney function decline post-AKI and initiate kidney protective measures in a timely fashion.

这强调了需要制定个性化的随访策略，以识别急性肾损伤（AKI）后肾功能下降，并及时启动肾脏保护措施。