尿石症是泌尿道感染患者罹患敗血性休克和急性腎衰竭的危險因子
蕭志彥1,5、賴韋宏2、陳宗賢3、洪培豪1,6、林慈珍4,7、江政倫1
戴德森醫療財團法人嘉義基督教醫院 內科部3 腎臟內科1，泌尿科2，專科護理師組4；嘉南藥理大學 醫務管理系5，生活應用與保健系6；崇仁醫護管理專科學校 護理科7
Urolithiasis is a risk factor for uroseptic shock and acute kidney injury in patients with urinary tract infection
Chih-Yen Hsiao1,5, Wei-Hong Lai2, Tsung-Hsien Chen3, Peir-Haur Hung1,6,
Tzu-Chen Lin4,7, Cheng-Lun Chiang1
1Division of Nephrology, 3Department of Internal Medicine, 2Division of Urology, 4Nurse Practitioner, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; 5Department of Hospital and Health Care Administration, 6Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 7Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chia-Yi County, Taiwan
Purpose: Urinary tract infection (UTI) is a common complication in patients with urolithiasis. This study aimed to compare the clinical manifestations and treatment outcomes among UTI patients with or without urolithiasis, and to identify the relationships among urolithiasis, uroseptic shock, and acute kidney injury (AKI).
Materials and Methods: This retrospective study enrolled hospitalized UTI patients for whom imaging was performed in anacute hospital care setting from January 2006 to March 2015.
Results: Of 662 participants enrolled, 113 (17.1%) had urolithiasis, 107 (16.2%) developed uroseptic shock, and 85 (12.8%) developed AKI. A multivariate logistic regression analysis showed that urolithiasis is associated with an increased risk of uroseptic shock (OR 1.88, 95% CI: 1.10−3.20, P = 0.021), AKI (OR 2.06, 95% CI: 1.14−3.75, P = 0.018), and bacteremia (OR 1.79, 95% CI: 1.14−2.82, P = 0.011) in UTI patients.
Conclusion: Urolithiasis is common in UTI patients and is associated with increased risk of uroseptic shock and AKI.