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目的回顾性分析克林霉素导致急性肾损伤(AKI)的临床特征、治疗及预后,旨在提高对克林霉素相关肾损害的认识。方法选取2008年8月~2012年11月昆明医科大学第一附属医院肾内科27例克林霉素治疗后出现AKI的患者进行分析。结果 20例(74.07%)接受血液净化治疗,7例(25.93%)患者接受口服透析治疗,出院后28天随访27例患者血清肌酐(SCr)均恢复正常。结论克林霉素导致肾脏损害的临床突出表现为恶心、呕吐、腰痛、腹痛、发作性肉眼血尿和少尿性AKI,罕见以往认为常见的发热、皮疹及嗜酸细胞增多等临床表现。约74%患者需要血液净化治疗,观察患者近期预后良好,远期肾功能需进一步观察。
Objective To retrospectively analyze the clinical features, treatment and prognosis of clindamycin-induced acute kidney injury (AKI), and to improve the understanding of clindamycin-related renal damage. Methods A total of 27 patients with AKI after clindamycin treatment in the Department of Nephrology, the First Affiliated Hospital of Kunming Medical University from August 2008 to November 2012 were analyzed. Results Twenty patients (74.07%) were treated with blood purification. Seven patients (25.93%) received oral dialysis. Serum creatinine (SCr) returned to normal after 27 days of discharge in 28 patients. Conclusion Clinical manifestations of clindamycin-induced renal damage are nausea, vomiting, low back pain, abdominal pain, episodes of gross hematuria and oliguric AKI, and rare clinical manifestations of fever, rash and eosinophilia common in the past. About 74% of patients need blood purification treatment, the recent observation of patients with good prognosis, long-term renal function needs further observation.