Relationship between elevated arterial blood lactate level and prognosis of patients with hemorrhagic fever with renal syndrome

doi:10.3877/cma.j.issn.2095-9133.2022.02.003

Abstract

Abstract:

Objective

To investigate whether the level of arterial blood lactic acid is related to the prognosis of patients with hemorrhagic fever with renal syndrome(HFRS).

Methods

A total of 41 patients with HFRS admitted to the Sun Yat-sen Memorial Hospital from January 2014 to December 2018 were retrospectively analyzed, including 33 males (80.5%) and 8 females (19.5%), aged from 19 to 73 years, with an average of (44.2±14.0) years old. The patients were divided into groups according to the recovery time of renal function. 22 cases in group A were defined as rapid recovery group (≤12 days), 11 cases in group B as slow recovery group (>12 days), and 8 cases in group C as non recovery group. The symptom characteristics, laboratory examination, treatment recovery time and prognosis were collected and statistically analyzed. According to the level of arterial blood lactate, the patients were divided into normal lactate group and elevated lactate group. The average recovery time of renal function, the proportion of blood purification treatment and the mortality of the two groups were compared.

Results

Among 41 patients with hemorrhagic fever with renal syndrome, renal function recovered in 33 cases (80.5%). The median time of renal function recovery was 12 days. 8 cases (19.5%) were treated with hemodialysis and 2 cases(4.9%)died. The average recovery time of renal function in the elevated lactic acid group was longer, the proportion of CRRT treatment was higher and the mortality was higher.

Conclusion

The increase of arterial bloodlactic acid level may predict the poor prognosis of patients with hemorrhagic fever with renal syndrome.

Key words: Hemorrhagic fever with renal syndrome, Acute kidney injury, Arterial blood lactic acid

Pengfei Wang, Huimin Zheng, Longyuan Jiang. Relationship between elevated arterial blood lactate level and prognosis of patients with hemorrhagic fever with renal syndrome[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2022, 08(02): 74-76.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhwsyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9133.2022.02.003

https://zhwsyjdzzz.cma-cmc.com.cn/EN/Y2022/V08/I02/74

Figures/Tables 2

References 10

1	李兰娟，任红．传染病学[M].8版，北京：人民卫生出版社，2013：140-143.
2	Bellomo R，Ronco C，Kellum JA，et al.Acute renal failure-definition，outcome measures，animal models, fluid therapy and information technology needs：the second international consensus conference of the acute dialysis quality initiative (ADQI) group[J]．Critical Care，2004，8(4)：R204-R212.
3	Huong VT，Yoshimatsu K，Luan VD，et al.Hemorrhagic fever with renal syndrome，vietnam[J]．Emerg Infect Dis，2010，16(2)：363-365.
4	Miettinen MH，Mäkelä SM，Ala-Houhala IO，et al.Ten-year prognosis of puumala hantavirus-induced acute interstitial nephritis[J]．Kidney Int，2006，69(11)：2043-2048.
5	汪君君，马涛，谢国祥，等．南京市2012年1月至2017年7月肾综合征出血热的流行特征与趋势预测[J/CD]．中华卫生应急电子杂志，2018，4(6)：47-53.
6	Liu W，Peng L，Hua S．Clinical significance of dynamic monitoring of blood lactic acid, oxygenation index and c-reactive protein levels in patients with severe pneumonia[J]. Exp Ther Med，2015，10(5)：1824-1828.
7	王璟，邱财荣，马黎军，等．早期应用连续性血液净化治疗危重型肾病综合征出血热的临床分析[J]．临床肾脏病杂志，2013，13(7)：3.
8	王珍，李国民，管双仙，等．降钙素原，N前端脑钠肽，乳酸对评估ICU脓毒症患者预后价值的研究[J/CD]．中华卫生应急电子杂志，2020，6(5)：284-287.
9	王标，王泽宇，徐蓉，等．乳酸/清蛋白比值与脓毒症患者MODS的发生率及病死率的相关性[J]．中国感染控制杂志，2017，16(5)：417-422.
10	颜海鹏，卢秀兰，仇君，等．血乳酸在脓毒症患儿病情及预后评价中的意义[J]．中国当代儿科杂志，2016，18(6)：506-510.

组别	例数	年龄(岁，±s)	性别		住院天数(d，±s)	肌酐基线估值(mmol/L，±s)	肌酐最高值(mmol/L，±s)
组别	例数	年龄(岁，±s)	男性	女性	住院天数(d，±s)	肌酐基线估值(mmol/L，±s)	肌酐最高值(mmol/L，±s)
A组	22	37.6±11.3	16(72.7)	6(27.3)	9.7±5.0	86±23	255(188~366)
B组	11	54.1±14.1^a	10(90.9)	1(9.1)	16.82±4.9^a	103±27	484(188~720)^a
C组	8	42.8±12.0	7(87.5)	1(12.5)	16.38±6.3^a	99±19	632(383~1253)^a
组别	例数	白细胞升高	血小板下降	乳酸升高	肝酶升高	降钙素原升高
A组	22	9(40.9)	9(40.9)	3(13.6)	12(54.5)	10(45.5)
B组	11	7(63.6)	5(45.5)	6(54.5)^a	8(72.7)	7(63.6)
C组	8	4(50.0)	5(62.5)	6(75.0)^a	5(62.5)	5(62.5)

组别	例数	年龄(岁，±s)	性别		住院天数(d，±s)	肌酐基线估值(mmol/L，±s)	肌酐最高值(mmol/L，±s)
组别	例数	年龄(岁，±s)	男性	女性	住院天数(d，±s)	肌酐基线估值(mmol/L，±s)	肌酐最高值(mmol/L，±s)
A组	22	37.6±11.3	16(72.7)	6(27.3)	9.7±5.0	86±23	255(188~366)
B组	11	54.1±14.1^a	10(90.9)	1(9.1)	16.82±4.9^a	103±27	484(188~720)^a
C组	8	42.8±12.0	7(87.5)	1(12.5)	16.38±6.3^a	99±19	632(383~1253)^a
组别	例数	白细胞升高	血小板下降	乳酸升高	肝酶升高	降钙素原升高
A组	22	9(40.9)	9(40.9)	3(13.6)	12(54.5)	10(45.5)
B组	11	7(63.6)	5(45.5)	6(54.5)^a	8(72.7)	7(63.6)
C组	8	4(50.0)	5(62.5)	6(75.0)^a	5(62.5)	5(62.5)

组别	例数	性别男性[例(%)]	年龄(岁)	肌酐基线值(估算)(mmol/L)	血液净化治疗[例(%)]	肾功能恢复时间(d)	死亡[例(%)]
正常组	24	20(83.3)	39±11	94±21	2(8.3)	9.9±4.6	0
升高组	17	13(76.5)	46±15	92±28	6(35.3)	17.1±5.7	2(11.8)
统计值		0.30	-1.61	-0.35	3.05	-4.45
P值		>0.05	>0.05	>0.05	>0.05	<0.05	>0.05

组别	例数	性别男性[例(%)]	年龄(岁)	肌酐基线值(估算)(mmol/L)	血液净化治疗[例(%)]	肾功能恢复时间(d)	死亡[例(%)]
正常组	24	20(83.3)	39±11	94±21	2(8.3)	9.9±4.6	0
升高组	17	13(76.5)	46±15	92±28	6(35.3)	17.1±5.7	2(11.8)
统计值		0.30	-1.61	-0.35	3.05	-4.45
P值		>0.05	>0.05	>0.05	>0.05	<0.05	>0.05

[1]	Jingqi Zhang, Yang Jiang, Jialu Sun, Xingzhe Tang, Yufei Zhao, Ying Cui, Xinxiang Li, Jingyue Dai, lin Fu, Xingui Peng. Early identification of sepsis with acute kidney injury by perirenal CT features combined with serum creatinine [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2024, 17(04): 285-292.
[2]	Heng Fan, Min Sun, Jianhua Zhu. Protective effect of salidroside on septic acute kidney injury in rats by inhibiting phosphatidylinositol 3 kinase/protein kinase B/mammalian target of rapamycin signal pathway [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2024, 17(03): 188-195.
[3]	Jinli Zhang, Maomao Xi, Zhigang Chu, Xiagang Luan, Nuo Chen, Deyun Wang, Weiguo Xie. Analysis of risk factors of early acute kidney injury in patients with massive burn injuries [J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(04): 282-287.
[4]	Rui Peng, Ruiwen Yang, Danning Wei, Yongliang Xia. Role of succinate receptor 1 in exacerbation of kidney ischemia-reperfusion injury [J]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(03): 159-164.
[5]	Branch of Organ Transplant of Chinese Medical Association, Branch of Organ Transplant Physicians of Chinese Medical Doctor Association. Clinical practice guidelines for kidney injury management of liver transplant recipients in China(2023 edition) [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(03): 276-288.
[6]	Xia Du, Mengqing Ma, Changchun Cao. Research progress on the pathogenesis and intervention targets of contrast-induced acute kidney injury [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(05): 279-282.
[7]	Junnan Guo, Hui Lin, Yilin Ren, Xi Qiao. Progress of research on the role of amino acid metabolism disturbance in the transition from AKI to CKD [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(05): 283-287.
[8]	Nan Yuan, Mengjie Huang, Yunfeng Bai, Xiaofan Li, Congjuan Luo, Jianwen Chen. Analysis of teaching points and learning effect in the establishment of an acute kidney injury-chronic kidney disease transition model in mice [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(04): 226-230.
[9]	Ling Lin, Jingru Li, Ruihua Shen, Hui Lin, Xi Qiao. Bioinformatics analysis of hub genes of acute kidney injury and acute lung injury in mice [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(03): 134-144.
[10]	Yinan Zhang, Guozhen Zhu. Research progress on the transition from acute kidney injury to chronic kidney disease [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(02): 106-112.
[11]	Jianfang Zhou, Xuying Luo, Linlin Zhang, Hongliang Li, Yanlin Yang, Guangqiang Chen, Guangzhi Shi. Incidence, risk factors, and prognostic impact of acute kidney injury in critically ill patients after craniotomy [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(02): 148-156.
[12]	Zengli Xiao, Anqi Du, Yao Sun, Huiying Zhao, Youzhong An. Risk factors analysis and nomogram establishment for patients developing AKI after intracerebral hemorrhage surgery [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2024, 10(02): 157-163.
[13]	Nan Si, Hongtao Sun. Research progress on risk factors of renal dysfunction after traumatic brain injury [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2024, 14(05): 300-305.
[14]	Yan Shen, Junfeng Zhang, Chunfang Tang. Predictive value of prognostic nutritional index combined with PCT，CysC，and RBP levels for acute pancreatitis complicated with acute kidney injury [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(06): 536-540.
[15]	Shirui Yan, Hui Xiong. Identification of risk factors for acute kidney injury in patients with infective endocarditis and prediction of death risk in such patients with acute kidney injury [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(07): 618-624.

Please choose a citation manager

Content to export