心脏手术后急性肾损伤早期用静脉袢利尿剂第7天肾恢复无明显差异：6289名患者、早期组74.8%对未用组74.0%，《科学报告》11月13日刊出
《科学报告》于 2026 年 11 月 13 日刊出一项研究，考察心脏手术相关急性肾损伤之后静脉袢利尿剂的启用时机与肾脏结局的关系，论文数字对象标识为 10.1038/s41598-026-77869-9。
静脉袢利尿剂常用于心脏手术相关急性肾损伤后的液体清除，但启用时机的影响一直不确定。研究团队用 MIMIC-IV 第 3.1 版数据库做了一项按目标试验原则设计的回顾性观察研究，把心脏手术后发生急性肾损伤的成人以首个符合 KDIGO 标准的急性肾损伤时间点为零点，按 72 小时内的启用时机分为早期组、晚期组与未用组，主要结局为第 7 天肾恢复。
在 6289 名患者中，早期组与未用组的第 7 天肾恢复没有明显差异，分别为 74.8% 与 74.0%，风险差为 0.77 个百分点，95% 置信区间为负 3.30 至 4.94。
这一结果在倾向评分重拟合自助法分析中仍与无效假设相容，置信区间为负 3.59 至 5.18；在限定 72 小时存活者的分析中，风险差为 0.27 个百分点，置信区间为负 3.76 至 4.36。
论文作者为 Jinjing Wu、Tiantian Sun、Sheng Wang 等人。作者指出，早期组与晚期组的次要结局对比样本较小、统计上脆弱，属探索性结果，不改变主要对比未见明确获益或损害的结论。研究获非传染性慢性疾病国家科技重大项目资助，编号为 2023ZD0504404。
（来源：《科学报告》）
Early Intravenous Loop Diuretics Show No Clear Difference in Day-7 Renal Recovery After Cardiac Surgery-Associated Acute Kidney Injury: 6,289 Patients, With 74.8 Percent in the Early Group Against 74.0 Percent in the None Group, Published in Scientific Reports on November 13
Scientific Reports published a study on November 13, 2026 on the timing of intravenous loop diuretics and renal outcomes after cardiac surgery-associated acute kidney injury, under DOI 10.1038/s41598-026-77869-9. Intravenous loop diuretics are frequently used for fluid removal after cardiac surgery-associated acute kidney injury, but the implications of initiation timing remain uncertain. The team used MIMIC-IV version 3.1 in a retrospective observational study informed by target-trial principles, assigning adults with acute kidney injury after cardiac surgery a time zero at the first qualifying KDIGO timestamp and classifying exposure timing within 72 hours as Early, Late or None. The primary outcome was Day-7 renal recovery. Among 6,289 patients, Early versus None showed no clear difference in Day-7 renal recovery, at 74.8 percent against 74.0 percent, a risk difference of 0.77 percentage points with a 95 percent confidence interval from negative 3.30 to 4.94. The finding remained compatible with the null in the propensity-score-refit bootstrap, with a confidence interval from negative 3.59 to 5.18, and in a 72-hour survivor-restricted analysis, with a risk difference of 0.27 percentage points and a confidence interval from negative 3.76 to 4.36. The authors, Jinjing Wu, Tiantian Sun, Sheng Wang and co-authors, note that secondary Early-versus-Late contrasts were exploratory and statistically fragile given the small Late group, and do not override the primary comparison. The work was supported by the Noncommunicable Chronic Diseases National Science and Technology Major Project under grant number 2023ZD0504404.
(Source: Scientific)
来源：《科学报告》
发布：GSM·美国（发布链接）
图片来源：图：医院的走廊。Eyluleyel，CC BY-SA 4.0，经 Wikimedia Commons。 / Photo: Eyluleyel, CC BY-SA 4.0, via Wikimedia Commons.
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