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目的:调查首都医科大学宣武医院成年住院患者药源性急性肾损伤（AKI）的发生情况。方法:调取首都医科大学宣武医院2014年1月1日至12月31日出院且住院期间诊断符合AKI的成年患者病历资料，按照AKI是否由药物引起，将患者分为药源性AKI组和非药源性AKI组。收集患者的基本信息、合并疾病、血肌酐（Scr）变化、出院转归、肾毒性药物使用情况及药源性AKI关联性评价结果并进行回顾性分析。结果:共592例AKI患者纳入本研究，药源性AKI组138例（23.31%），非药源性AKI组454例（76.69%），2组患者性别、年龄、住院天数、合并疾病、入院时Scr水平、入院后Scr达峰值时间及出院转归的差异均无统计学意义（均n P>0.05）；药源性AKI组住院期间和出院时Scr峰值（178 μmol/L，116 μmol/L）均显著高于非药源性AKI组（129 μmol/L，103 μmol/L），差异均有统计学意义（n P<0.001，n P=0.001）。药源性AKI组138例患者共涉及231例次可疑药物，居前6位的药物类别依次为抗感染药81例次（35.06%）、利尿药40例次（17.32%）、造影剂31例次（13.42%）、血浆代用品23例次（9.96%），血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂19例次（8.23%）和非甾体抗炎药16例次（6.93%）。造影剂和血浆代用品致AKI发生的时间最短，范围为1~3 d，抗感染药致AKI发生的时间最长，范围为1~12 d；与非甾体抗炎药和造影剂相关AKI患者住院期间Scr峰值较低[118（103，300）μmol/L，133（90，243）μmol/L]；抗感染药致AKI患者住院期间Scr峰值最高[223（138，396）μmol/L]。多因素logistic回归分析结果显示，低蛋白血症（n OR=8.369，95n %CI: 3.379~20.724，n P0.05 for all). Peak value of Scr during hospitalization and at discharge in patients in the drug-induced AKI group (178 μmol/L, 116 μmol/L) were obviously higher than those in the non-drug-induced AKI group (129 μmol/L, 103 μmol/L), and the differences were statistically significant ( n P<0.001, n P=0.001). A total of 231 times of suspected drugs were involved in the 138 patients in the drug-induced AKI group. The top 6 types of drugs in turn were anti-infectious agents (35.06%, 81/231), diuretics (17.32%, 40/231), contrast agents (13.42%, 31/231), plasma substitutes (9.96%, 23/231), angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blocker (8.23%, 19/231), and non-steroidal anti-inflammatory drugs (NSAIDs) (6.93%, 16/231). Contrast agents and plasma substitutes had the shortest (range: 1-3 days) but anti-infectious agents had the longest time (range: 1-12 days) from medication to AKI occurrence. Peak values of Scr in AKI inpatients caused by NSAIDs and contrast agents were lower [median value: 118 (103, 300) μmol/L, 133 (90, 243) μmol/L], but in those caused by anti-infectious agents was the highest [median value: 223 (138, 396) μmol/L]. Multivariate logistic regression analysis showed that hypoproteinemia ( n OR=8.369, 95n %CI: 3.379-20.724, n P<0.001) and advanced age (n OR=1.689, 95n %CI: 1.206-2.365, n P=0.002 for every 10 years of aging) were independent risk factors related to the death of patients with drug-induced AKI.n Conclusions:The patients with AKI induced by drugs accounts for 23.31% of all AKI adult inpatients in Xuanwu Hospital, Capital Medical University. Anti-infectious agents, diuretics, and contrast agents are the most common suspected pathogenic drugs. Hypoproteinemia and advanced age are independent risk factors for hospital deaths in drug-induced AKI patients.