Etiology and Short term Outcome of Acute Kidney Injury (AKI) in Hospitalized Patients : A Single Center Study (original) (raw)
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Epidemiology of acute kidney injury in Intensive Care Units in Aswan University Hospital
The Egyptian Journal of Hospital Medicine, 2020
Background: Acute kidney injury (AKI) is a frequent complication in patients admitted to the intensive care unit (ICU) and is associated with adverse outcomes including increased length of ICU and hospital stay, development of chronic kidney disease (CKD) and increased short-and long-term mortality risk. Objective: To screen critically ill patient admitted to ICU in Aswan University Hospital for acute kidney injury from September 2017 up to September 2018. Patients and methods: In this study 538 patients were admitted to the ICU in Aswan University Hospital in Egypt, from August 1 st , 2017 to August 1 st 2018. This study was a prospective, randomized; hospital based clinical study on critically ill patients in Intensive Care Unit. With inclusion criteria patients who were 18 years or older and admitted to the Intensive Care Unit (ICU). Results: Out of 583 patients admitted to ICU, there were 97 patients had AKI, 64.9% of them already had AKI on the admission while the rest of them (35.1%) developed AKI after admission. There is more than one third of mortality among ICU patients related to AKI (35.1%), while (64.9%) were related to other causes. Conclusion: AKI is associated with high mortality in our ICU setting. Further studies are needed to estimate the burden of AKI among patients before ICU admission.
Epidemiology of Acute Kidney Injury (AKI) among Hospitalized.pdf
Background: Acute kidney injury (AKI) is a syndrome characterized by decreased glomerular filtration. The spectrum of AKI ranges from minimal elevations in serum creatinine (SCr) to complete anuric kidney failure. Despite ample knowledge of the biologic basis of AKI, descriptions of the incidence, risk factors, sequelae, and outcomes of AKI remain relatively limited or have been based upon older descriptions without reflecting the most current definitions or practice patterns.
Kidney International, 2020
I n 2012, Kidney Disease: Improving Global Outcomes (KDIGO) published a guideline on the classification and management of acute kidney injury (AKI). 1 Since then, new evidence has emerged that has important implications for clinical practice. Large epidemiology studies and risk profiles for AKI have become available in adults and children, such as the AKI-Epidemiologic Prospective Investigation (AKI-EPI) study, 2 the 0by25 Initiative, 3 the Southeast Asia-AKI (SEA-AKI) study, 4 and the Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology (AWARE) 5 and Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) 6 studies. The effectiveness of the KDIGO recommendations in preventing AKI has been confirmed in small single-center randomized controlled trials (RCTs), such as the Prevention of AKI (PrevAKI) 7 and the
"Etiology of Acute Kidney Injury in a Tertiary Care Hospital"
IOSR Journals , 2019
Acute kidney injury is one of the significant causes of morbidity and mortality world wide. The present study was done in a tertiary care hospital in East Godavari District , Andhra Pradesh, India, among 100 patients of acute kidney injury with an objective to find out the most common causes of AKI in this particular area. Results showed that the major causes of AKI in this area are sepsis, gastroenteritis, heart failure and malaria.
Journal of Enam Medical College
Background: Acute kidney injury (AKI) is a public health issue associated with multiple clinical conditions which may occur due to slight elevation in serum creatinine to anuric renal failure with electrolytes and acid-base imbalance, chronic kidney diseases, end-stage renal diseases, impaired innate immunity associated with higher infection rate, and increased duration of hospital stay with higher cost. Sometimes severe AKI patients may need intensive care support and renal replacement therapy. Severe sepsis is the most common cause of ICU admission. Materials and Methods: This observational study was conducted during the period of July 2018 to May 2019 in the Department of Anesthesiology and Intensive Care Unit of Enam Medical College & Hospital, Savar Dhaka. A total of 87 AKI patients were selected among which 48 were male and 39 were female. Acute kidney injury was selected with an increase in serum creatinine >0.3 mg /dL within 48 hours or ≥1.5 mg /dL from the base line with...
International Journal of Nephrology and Renovascular Disease
Background: Acute kidney injury (AKI) is a common complication in hospitalized patients and a marker for poor patient outcomes. It is associated with a high risk of mortality and other short-and long-term adverse outcomes. We aim to assess the clinical profile and shortterm outcomes of acute kidney injury in adult patients admitted to the medical ward. Methods: A hospital-based prospective observational study was conducted from October 2019 to January 2020. All adult patients diagnosed as AKI using kidney disease improving global outcomes (KIDGO) criteria were included in the study and prospectively followed to document the short-term outcomes. Outcomes and their predictors were determined using multivariate logistic regression. P-value less than 0.05 was taken as statistically significant. Results: A total of 160 patients were included in the study. Out of this, 96 (60%) were males, 118 (74%) had community-acquired AKI, and 51 (32%) had stage 3 AKI. Common causes of AKI were hypovolemia 62 (39%) and sepsis 35 (22%). Hypertension 69 (43%) and heart failure 50 (31%) were common underlying comorbidities. Fifty-six (35%) patients developed systemic complications, 98 (61.2%) had persistent AKI, 136 (85%) had prolonged length of hospital stay, and 18 (11%) were readmitted to the hospital. The presence of AKI-related complication (AOR=2.7, 95% CI: 1.14-6.58, p=0.024), and duration of AKI (AOR=9.7, 95% CI: 2.56-36.98, p=0.001) were factors associated with prolonged length of hospital stay. Preexisting CKD (AOR=3.6, 95% CI: 1.02-13.14, p=0.035) and stage 3 AKI (AOR=2.1, 95% CI: 1.6-3.57, p=0.04) were factors associated with 30-day hospital readmission. Conclusion: Hypovolemia and infections were the primary causes of AKI. Complications, prolonged length of hospital stay, persistent AKI, and rehospitalization were poor short-term outcomes of AKI. Early diagnosis and timely management of AKI particularly in high-risk hospitalized patients, and post-AKI care including management of comorbidities for AKI survivors should improve these poor short-term outcomes.
Acute Kidney Injury: Its Etiological Factors, Co-Morbidities and Mortality Risk
2020
AKI (Acute Kidney Injury) constitutes approximately 5-7% of hospital admissions and up to 30% of admissions to intensive care units. Large referrals to dialysis units suggest that the condition is more common in Pakistan. The study was conducted to identify the etiological factors, co-morbidities and mortality risk in AKI.
Acute Kidney Injury: Epidemiology, Diagnosis, Prognosis, and Future Directions
European medical journal, 2015
Acute kidney injury (AKI) is a common problem highly associated with hospitalisation. AKI is the cause of harmful short-term consequences: longer hospital stays, greater disability after discharge, and greater risk of in-hospital mortality, as well as adverse long-term outcomes, such as progression to chronic kidney disease, development of cardiovascular disease, and increased risk of long-term mortality. The concept of AKI has changed since the introduction of the 'Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease' (RIFLE) classification. More recently, the 'Kidney Disease Improving Global Outcomes' (KDIGO) classification appears to have provided increased diagnostic sensitivity and outcome-prediction capability. Novel biomarkers and further research on the role of the immune system in AKI may help improve the diagnosis, severity, outcome evaluation, and treatment of the condition. In this review we describe the epidemiology, diagnosis, and prognosis of AKI, as well as possible future directions for its clinical management.
Acute kidney injury: an increasing global concern
The Lancet
Despite an increasing incidence of acute kidney injury in both high-income and low-income countries and growing insight into the causes and mechanisms of disease, few preventive and therapeutic options exist. Even small acute changes in kidney function can result in short-term and long-term complications, including chronic kidney disease, end-stage renal disease, and death. Presence of more than one comorbidity results in high severity of illness scores in all medical settings. Development or progression of chronic kidney disease after one or more episode of acute kidney injury could have striking socioeconomic and public health outcomes for all countries. Concerted international action encompassing many medical disciplines is needed to aid early recognition and management of acute kidney injury.
2022
Objectives: Acute Kidney Injury (AKI) is a very common clinical problem. This picture is seen in 5-7% of hospitalized patients and in 25-30% of patients hospitalized in intensive care units. The aim of this study was to determine the incidence, etiology, clinical features, prognosis and complications in adult patients hospitalized with of AKI. Methods: This study was organized as an observation study in which the files of the patients admitted to internal medicine and nephrology clinics between September 2012 and September 2017 were examined. All patients admitted to the internal medicine and nephrology clinics with the diagnosis of AKI were included in the study. But those under the age of 18, patients with chronic kidney damage, ex-patients after hospitalization, patients who were sent to the intensive care unit after hospitalization, patients who voluntarily refused treatment or left the service and who were hospitalized for more than 48 hours, but those who did not have biochemical analysis during their stay were excluded. RIFLE creatinine criteria were used for AKI identification. Results: The study included 354 patients. 177 (50%) patients were male and 177 (50%) patients were female. The incidence of prerenal AKI in the internal medicine and nephrology clinics was 53.39%, renal AKI was 36.44% and postrenal AKI was 10.17%. When the causes of AKI were examined, 33.9% hypovolemia, 15.5% UTI and 13.5% gastroenteritis were detected. The dialysis rate was 23.7%. Conclusion: Inconclusion, although the incidence of AKI is acceptable in our hospital. It is found to be compatible with the literature and it is possible to catch the early stage of injury by decreasing the frequency especially with better management of elderly patients and more closely monitoring renal functions in this group of patients