Paediatric acute kidney injury hospital admissions in England 1997–2014: burden and risk factors

The worldwide incidence of acute kidney injury (AKI) is increasing. Recent surveys demonstrated that AKI occurs in 21% of hospital admissions. In low-income countries, AKI has a bimodal presentation. In large urban centers, the pattern of AKI is very similar to that found in high and upper middle-income countries, with a predominance of hospital-acquired AKI, occurring mostly in older, critically ill, multiorgan failure patients with comorbidities. At the same time, in regional hospitals in small urban communities and rural areas, AKI is usually a community-acquired disease (related to diarrheal and infectious diseases, animal venom, and septic abortion). Although AKI mortality seems to be decreasing, it remains extremely high, varying from 23.9 to 60% in recent series. The most important risk factors for short-term mortality (in hospital or < 90 days) in AKI are the primary diagnosis (sepsis) and the severity of the acute illness, expressed by the presence of nonrenal organ dysfunction. New biomarkers, such as urinary neutrophil gelatinase-associated lipocalin, cystatin C, and interleukin-18 measurements, have been able to identify patients with AKI who are at risk for a less favorable prognosis, such as the likelihood of the need for renal replacement therapy, nonrecovery of kidney function, and higher mortality. Several studies have demonstrated an association between hospital-associated AKI and postdischarge mortality in a variety of contexts, and the most important risk factors for this late lethality are older age, preexisting comorbid disease (chronic kidney disease [CKD], cardiovascular disease, or malignancy), and incomplete organ recovery with ongoing residual disease. AKI is associated with de novo end-stage renal disease (ESRD) (CKD, progression of preexisting CKD) and the occurrence of ESRD in the long term. Herein, it is suggested that high-risk patients recovering from an AKI episode, such as those with baseline CKD, diabetes mellitus, or heart failure and those dialyzed for AKI, should likely be followed by a nephrologist.

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Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States

Diseases ◽

10.3390/diseases8030028 ◽

2020 ◽

Vol 8 (3) ◽

pp. 28

Author(s):

Charat Thongprayoon ◽

Fawad Qureshi ◽

Tananchai Petnak ◽

Wisit Cheungpasitporn ◽

Api Chewcharat ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Resource Utilization ◽

Hospital Admissions ◽

Heat Stroke ◽

Kidney Injury ◽

Length Of Hospital Stay ◽

The United States

This study aims to evaluate the risk factors and the association of acute kidney injury with treatments, complications, outcomes, and resource utilization in patients hospitalized for heat stroke in the United States. Hospitalized patients from years 2003 to 2014 with a primary diagnosis of heat stroke were identified in the National Inpatient Sample dataset. End stage kidney disease patients were excluded. The occurrence of acute kidney injury during hospitalization was identified using the hospital diagnosis code. The associations between acute kidney injury and clinical characteristics, in-hospital treatments, outcomes, and resource utilization were assessed using multivariable analyses. A total of 3346 hospital admissions were included in the analysis. Acute kidney injury occurred in 1206 (36%) admissions, of which 49 (1.5%) required dialysis. The risk factors for acute kidney injury included age 20–39 years, African American race, obesity, chronic kidney disease, congestive heart failure, and rhabdomyolysis, whereas age <20 or ≥60 years were associated with lower risk of acute kidney injury. The need for mechanical ventilation and blood transfusion was higher when acute kidney injury occurred. Acute kidney injury was associated with electrolyte and acid-base derangements, sepsis, acute myocardial infarction, ventricular arrhythmia or cardiac arrest, respiratory, circulatory, liver, neurological, hematological failure, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher in acute kidney injury patients. Approximately one third of heat stroke patients developed acute kidney injury during hospitalization. Acute kidney injury was associated with several complications, and higher mortality and resource utilization.

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Acute Kidney Injury in Hospitalized Patients Infected with COVID-19 from Wuhan, China: A Retrospective Study

BioMed Research International ◽

10.1155/2021/6655185 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yujie Dai ◽

Zhifen Liu ◽

Xingguo Du ◽

Honglan Wei ◽

Yang Wu ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Hospital Admissions ◽

Kidney Injury ◽

Outcome Data ◽

Study Results ◽

Significant Difference ◽

Novel Coronavirus

Background. Since the first diagnosed case of infection with the novel coronavirus (SARS-CoV-2), there has been a rapid spread of the disease with an increasing number of cases confirmed every day, as well as a rising death toll. An association has been reported between acute kidney injury (AKI) and mortality in patients infected with SARS-CoV-2. Therefore, our study was conducted to explore possible risk factors of AKI as well as whether AKI was a risk factor for worse outcome, especially mortality among patients with coronavirus disease (COVID-19). Methods. We included all hospital admissions with confirmed or clinically diagnosed COVID-19 from January 29 to February 25, 2020. We collected demographic and epidemiological information, past medical history, symptoms, laboratory tests, treatments, and outcome data from electronic medical records. A total of 492 patients with diagnosed or clinically diagnosed COVID-19 were included in this study. Results. The prevalence rate of AKI was 7.32%. Among the factors associated with AKI, males versus females (aOR 2.73), chronic kidney disease (aOR 42.2), hypertension (aOR 2.82), increased leucocytes (aOR 6.08), and diuretic use (aOR 7.89) were identified as independent risk factors for AKI among patients infected by SARS-CoV-2. There was a significant difference in hospital fees and death in patients with and without AKI ( p < 0.05 ). The mortality rate in patients with AKI was 63.9%. Conclusions. AKI was widespread among patients with COVID-19. The risk factors of AKI in COVID-19 patients included sex, chronic kidney disease, hypertension, infection, and diuretic use. AKI may be associated with a worse outcome, especially mortality in COVID-19 patients.

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Epidemiology of Acute Kidney Injury

10.2310/nephro.12033 ◽

2017 ◽

Author(s):

Verônica Torres Costa e Silva ◽

Renato Antunes Caires ◽

Elerson Carlos Costalonga ◽

Emmanuel A. Burdmann

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Low Income ◽

Rural Areas ◽

Hospital Admissions ◽

De Novo ◽

Residual Disease ◽

Multiorgan Failure ◽

Kidney Injury ◽

Low Income Countries

The worldwide incidence of acute kidney injury (AKI) is increasing. Recent surveys demonstrated that AKI occurs in 21% of hospital admissions. In low-income countries, AKI has a bimodal presentation. In large urban centers, the pattern of AKI is very similar to that found in high and upper middle-income countries, with a predominance of hospital-acquired AKI, occurring mostly in older, critically ill, multiorgan failure patients with comorbidities. At the same time, in regional hospitals in small urban communities and rural areas, AKI is usually a community-acquired disease (related to diarrheal and infectious diseases, animal venom, and septic abortion). Although AKI mortality seems to be decreasing, it remains extremely high, varying from 23.9 to 60% in recent series. The most important risk factors for short-term mortality (in hospital or < 90 days) in AKI are the primary diagnosis (sepsis) and the severity of the acute illness, expressed by the presence of nonrenal organ dysfunction. New biomarkers, such as urinary neutrophil gelatinase-associated lipocalin, cystatin C, and interleukin-18 measurements, have been able to identify patients with AKI who are at risk for a less favorable prognosis, such as the likelihood of the need for renal replacement therapy, nonrecovery of kidney function, and higher mortality. Several studies have demonstrated an association between hospital-associated AKI and postdischarge mortality in a variety of contexts, and the most important risk factors for this late lethality are older age, preexisting comorbid disease (chronic kidney disease [CKD], cardiovascular disease, or malignancy), and incomplete organ recovery with ongoing residual disease. AKI is associated with de novo end-stage renal disease (ESRD) (CKD, progression of preexisting CKD) and the occurrence of ESRD in the long term. Herein, it is suggested that high-risk patients recovering from an AKI episode, such as those with baseline CKD, diabetes mellitus, or heart failure and those dialyzed for AKI, should likely be followed by a nephrologist.

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Review for "Risk factors for high‐dose methotrexate associated acute kidney injury in patients with hematological malignancies"

10.1002/hon.2759/v1/review1 ◽

2019 ◽

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Hematological Malignancies ◽

Kidney Injury ◽

High Dose ◽

High Dose Methotrexate ◽

Dose Methotrexate

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Acute kidney injury in preterm neonates with ≤30 weeks of gestational age and its risk factors

Minerva Pediatrica ◽

10.23736/s0026-4946.18.04964-2 ◽

2019 ◽

Vol 71 (5) ◽

Author(s):

Rita Ladeiras ◽

Filipa Flor-De-Lima ◽

Henrique Soares ◽

Bárbara Oliveira ◽

Hercília Guimarães

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Gestational Age ◽

Kidney Injury ◽

Preterm Neonates

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KIDNEY INJURY IN CANCER THERAPY

Nephrology (Saint-Petersburg) ◽

10.24884/1561-6274-2018-22-5-17-24 ◽

2018 ◽

Vol 22 (5) ◽

pp. 17-24 ◽

Cited By ~ 1

Author(s):

E. V. Burnasheva ◽

Y. V. Shatokhin ◽

I. V. Snezhko ◽

A. A. Matsuga

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Cancer Therapy ◽

Cancer Patients ◽

Cytotoxic Effect ◽

Tumor Lysis Syndrome ◽

Kidney Injury ◽

Chemotherapeutic Agents ◽

Oxygen Intermediates ◽

Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular injury, nephrotoxic drugs including chemotherapeutic agents. Also bone marrow transplantation complications, infections with immune suppression (including septicemia), tumor lysis syndrome should be taken into account. Chemotherapeutic agents are a common cause of acute kidney injury but can potentially lead to chronic kidney disease development in cancer patients. This article summarizes risk factors of acute kidney injury in cancer patients. Risk factors are divided into two groups. The systemic are decrease of total circulating blood volume, infiltration of kidney tissue by tumor cells, dysproteinemia, electrolyte disturbances. The local (renal) risk factors are microcirculation disturbances, drugs biotransformation with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its sensitivity to ischemia. Drug-related risk factors include: drugs combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular precipitates. Early diagnosis, timely prevention and treatment of these complications provide significantly improve nononcologic results of treatment.

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