Acute kidney injury in the elderly patients of Thai-surgical intensive care units (Thai-SICU) study

2017 ◽  
Vol 30 (2) ◽  
pp. 131
Author(s):  
Konlawij Trongtrakul ◽  
Sujaree Poopipatpab ◽  
Ploynapas Limphunudom ◽  
Chawika Pisitsak ◽  
Kaweesak chittawatanarat ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Elderly Patients ◽  
Intensive Care Units ◽  
Kidney Injury ◽  
The Elderly ◽  
Surgical Intensive Care

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

Survival and renal recovery after acute kidney injury requiring dialysis outside of intensive care units

2020 ◽  
Vol 52 (12) ◽  
pp. 2367-2377
Author(s):  
Silvia González Sanchidrián ◽  
Javier L. Deira Lorenzo ◽  
M. Jimena Muciño Bermejo ◽  
Pedro J. Labrador Gómez ◽  
Juan R. Gómez-Martino Arroyo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Kidney Injury ◽  
Renal Recovery

scholarly journals P0597TRAINING IS NOT ENOUGH: RESISTANCE TO THE APPLICATION OF THE AGREED CRITERIA (KDIGO) FOR THE DIAGNOSIS OF ACUTE KIDNEY INJURY IN INTENSIVE CARE UNITS IN EGYPT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Samar Abd ElHafeez ◽  
Yasmine Naga ◽  
Graziella D'arrigo ◽  
Giovanni Tripepi ◽  
Carmine Zoccali
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Clinical Diagnosis ◽  
Kidney Injury ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Icu Admission ◽  
Kdigo Guidelines ◽  
University Teaching Hospitals

Abstract Background and Aims Acute kidney injury (AKI) is one of the most serious complications of patients admitted to intensive care units (ICUs). It is associated with high short- and long-term mortality and resource utilization. The definition of AKI has been established by the KDIGO guidelines based on changes in serum creatinine, urine output or both. However, in clinical practice physicians may ignore the standard criteria and rely on clinical judgement. We therefore aimed to assess the degree of physicians’ compliance with the KDIGO guidelines in diagnosis of AKI. Method We collected data (demographic, clinical, and biochemical) in a multicenter prospective cohort study from all adults admitted to ICUs (10 surgical and 8 medical) units at Alexandria University Teaching Hospitals from February 1st, 2016 till August 1st, 2016. Alexandria Teaching Hospitals cover four governorates of Northern Egypt and serve approximately 14 million people. Doctors were preliminarily instructed to apply KDIGO criteria for the diagnosis of AKI. Personal and clinical experience data were collected from the treating physicians. We followed patients for thirty days from study entry until discharge, death or study end. Written informed consent was obtained from all participants. AKI was defined and classified based on KDIGO 2012 criteria. In parallel, we registered the actual clinical diagnosis made by the treating physicians. We used frequencies and means for qualitative and quantitative variables as appropriate. Results The study included 532 patients who were on average 46 year old (±18), 41.7% were males, 23.5% with smoking, 23.1% had diabetes, 34.8%, were hypertensive, 11.3 % with pre-existing chronic kidney disease, and 30.1% had cardiovascular diseases. There were 140 physicians responsible for treating the enrolled subjects, with mean age 30 ±3 years, 57% were males, 20% were nephrologists, and the median years of experience was 3 years (inter-quartile range: 2-4years). The AKI incidence was 62.2% according to KDIGO criteria versus 49.9% based on the clinical diagnosis of treating physicians. Among those not reported to have AKI by the treating physicians; 19.1% were in stage 1, 26.4% in stage 2, and 12.9% in stage 3 AKI based on KDIGO. About 24% of patients who had AKI at ICU admission and 15% of those who developed AKI after ICU admission were not appropriately identified as AKI patients according to the physicians. There was a significant association between the physician speciality (nephrology vs other specialties) and the correct AKI diagnosis based on KDIGO criteria (X2=47.06, p<0.001). Conclusion To streamline a correct and timely identification of AKI, treating physicians in ICUs at a large hospital in North Africa, like the Alexandria University Teaching Hospitals in Egypt, need well focused training and knowledge verification post training on KDIGO guidelines for identifying AKI patients. Implementation of electronic alerts could help in proper diagnosis and management.

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