scholarly journals P0609THE INCIDENCE AND RISK OF CONTRAST INDUCED ACUTE KIDNEY INJURY IN THE ELDERLY UNDERGOING PULMONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alrowaie Fadel ◽  
Khalid Almatham ◽  
Saud Almousa ◽  
Majed Abonab ◽  
Abdullah AlJaser ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Computed Tomography Angiography ◽  
Tertiary Care ◽  
Kidney Injury ◽  
The Elderly ◽  
Base Line ◽  
Care Hospital ◽  
Prophylactic Measures

Abstract Background and Aims Contrast-induced acute kidney injury nephropathy (CI-AKI) is a leading cause of acquired acute kidney injury and has been associated with prolonged hospitalization and adverse clinical outcomes. Advanced age has been reported as risk factor for CI-AKI. However, limited studies available to determine the exact incidence of CI-AKI in elderly patient. The aim of this study was to investigate the incidence of, risk factors for developing CI-AKI in patient above 65 years old who underwent Pulmonary Computed Tomography Angiography (PCTA). Method This single center retrospective study, performed in a large, tertiary care hospital in Riyadh, Saudi Arabia. It is a sub-study of (3 P-CIAKI) The Practice Pattern of Preventive Measures for Contrast Induced Acute Kidney Injury in Patients Undergoing Pulmonary Computed Tomography Angiography. Patients > 65 years of age, who underwent PCTA during a 5-year period (2014 to 2018) were included. Patients receiving long-term hemodialysis or peritoneal dialysis, and those without repeated serum creatinine 48-72 hours post procedure were excluded from the analysis. CI-AKI defined as raise of serum creatinine by 44 mmol/l 48-72 hours post PCTA. Results 272 out of 908 patients, with a mean age of 74.93 ± 7.09 years, 58.1% having diabetes mellitus (DM) and estimated GFR of 74.92 ± 23.57 ml/min per 1.73 m2 were enrolled. 201 patients (73.9%) had eGFR > 60 ml/min. Diuretics was used by 37.1% of the patients, while 33.1 % of the patients on ACEI / ARBs. Prophylactic measures used in 35.7 % of the procedures. CI-AKI occurred in 19 cases (7.0 %) as compared with 4.7 % in the original 3 P-CIAKI study with mean age of 52 years and eGFR 97 ml/min. Renal replacement therapy required in 3 patients who had CI-AKI. DM status was only significant predictor for the development of CI-AKI. Conclusion Elderly patients are at greater risk for the development of CI-AKI even with eGFR above 60 ml/min specially in DM patient .The Incidence of CI-AKI in patients > 65 years of age is up to 7 %, that is less than the reported in the literature and this can be explained by higher base line eGFR in our study .

scholarly journals INCIDENCE AND CAUSES OF ACUTE KIDNEY INJURY IN SICK NEONATE : A STUDY FROM A TERTIARY CARE NEONATAL UNIT

2020 ◽  
pp. 1-2
Author(s):  
Krishnendu Karmakar ◽  
Sumanta Laha ◽  
Bhaswati Ghoshal ◽  
Pradip Kumar Das
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Normal Birth

Objective To find out the incidence of Acute Kidney Injury(AKI) and various causes responsible for the AKI in sick neonates in a tertiary care hospital. Material and Method In this observational cross sectional study we included all neonates with features suggestive of AKI with exclusion criteria of extreme prematurity, chronic kidney disease and major congenital anomaly. We diagnose AKI according to the KIDIGO(Kidney Disease: Improving Global Outcome)guideline where we take serum creatinine value and urinary output as determinant. Serum creatinine value measured at 48 and 72 hrs of admission and repeated at 96 hrs if there is rising trend of creatinine..Now we find out the incidence of AKI in relation to gender, birth weight, mode of delivary . Among the AKI case we sort out the causative factors like perinatal asphyxia,sepsis, shock, prematurity etc and analysed all the results statistically. Results Out of total 1872 neonates admitted during the 18 months study period we found AKI in 111 neonates(5.93%).There is male preponderance and most neonates are of normal birth wt.Among the various causes of AKI perinatal asphyxia is the leading cause followed by sepsis and prematurity.Other imp causes are congenital heart disease,shock, PPHN , nephrotoxic drug use and RDS of newborn. We found asphyxia as the leading cause of AKI in normal vaginal delivary group whereas sepsis is the main cause of AKI in cesarean section group. Conclusion AKI is fairly common in sick neonates , even in normal birth weight babies and perinatal asphyxia and sepsis are the two most prevalent cause for AKI in this study.

scholarly journals Pattern of acute kidney injury and its outcome in a tertiary care centre

2020 ◽  
Vol 8 (2) ◽  
pp. 618
Author(s):  
Jennie Santhanam ◽  
Meenakshi Sundari Subramaniyan Natarajan ◽  
Annam Lakshmanan ◽  
Rajeswari K. Balakrishnan
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Disease Category ◽  
The Mean

Background: Acute kidney injury is a multiplex disease with severe morbidity and mortality. The trends of acute kidney injury vary according to the regions and the population under study. The aim of this study is to evaluate the trends of acute kidney injury and its outcome in a tertiary care hospital.Methods: The study was a prospective observational study conducted at a tertiary care hospital in a metropolitan city. A total of 102 patients of acute kidney injury were selected based on the Kidney Disease Improving Global Outcomes guidelines of acute kidney injury. The main trends of acute kidney injury presentation and its outcome were assessed.Results: Of 102 patients admitted, 42 had a sepsis related diagnosis (42.41%), 17 patients (17.16%) had cardiovascular disease related acute kidney injury and 12 patients (12.12%) had developed acute kidney injury due to drugs and poisons. According to RIFLE (risk of renal failure, injury to kidney, failure and loss of function and end-stage kidney disease) category, 43.96% of patients belonged to the risk category and 30.77% to the injury category. Of 34 patients in failure category, 23 recovered and 11 did not recover. Authors compared the trends of acute kidney injury in patients who recovered and who deteriorated. The mean serum creatinine values were 3.42 mg/dl in patients who didn’t recover from acute kidney injury and 2.05 mg/dl in patients who recovered. In patients of the recovered group, the mean urine output value is 783 ml/day; in deterioration group, 445 ml/day.Conclusions: Most common etiologies of acute kidney injury in this study include sepsis, drugs and poisons, cardiovascular diseases and diarrheal diseases in order of occurrence. High serum creatinine at admission and oliguria were the most common factors that contributed to deterioration in acute kidney injury.

scholarly journals Acute kidney injury among paediatric emergency room admissions in a tertiary hospital in South West Nigeria: a cohort study

2018 ◽  
Vol 12 (4) ◽  
pp. 521-526 ◽  
Author(s):  
Adebowale D Ademola ◽  
Adanze O Asinobi ◽  
Esther Ekpe-Adewuyi ◽  
Adejumoke I Ayede ◽  
Samuel O Ajayi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Emergency Room ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Care Hospital ◽  
College Hospital ◽  
Paediatric Emergency ◽  
Sub Saharan

Abstract Background Epidemiological data on paediatric acute kidney injury (AKI) in sub-Saharan Africa are limited and largely retrospective. We performed a prospective study of AKI among patients admitted through the emergency room. Methods Children admitted to the post-neonatal emergency room of the University College Hospital, Ibadan, Nigeria between February 2016 and January 2017 were studied. AKI was defined by Kidney Disease: Improving Global Outcomes serum creatinine criteria. AKI ascertainment relied on serum creatinine measurements carried out in routine care by post-admission Day 1. We compared in-hospital mortality by post-admission Day 7 for patients with and without AKI (no-AKI). Results Of the 1344 children admitted to the emergency room, 331 were included in the study. AKI occurred in 112 patients (33.8%) with a median age of 3.1 years [interquartile range (IQR) 0.9–9.4] and was Stage 3 in 50.5% of the cases. The no-AKI group had a median age of 1.8 (IQR 0.7–5.8) years. The underlying diagnoses in patients with AKI were sepsis (33.0%), malaria (12.5%) and primary renal disorders (13.4%). Twenty-four of the patients with AKI underwent dialysis: haemodialysis in 20 and peritoneal dialysis in 4. By Day 7 of admission, 7 of 98 (7.1%) patients in the AKI group had died compared with 5 of 175 (2.9%) patients in the no-AKI group [odds ratio 2.6 (95% confidence interval 0.8–8.5)]. Outcome data were not available for 58 (17.5%) patients. Conclusions AKI is common among paediatric emergency room admissions in a tertiary care hospital in sub-Saharan Africa. It is associated with high mortality risk that may be worse in settings without dialysis.

scholarly journals Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

2020 ◽  
Author(s):  
VS Gaurav Narayan ◽  
SG Ramya ◽  
Sonal Rajesh Kumar ◽  
SK Nellaiappa Ganesan
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Rapid Decline ◽  
Care Hospital ◽  
Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

A CLINICAL STUDY OF ETIOLOGY, OUTCOME AND PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AMONG ICU ADMISSIONS IN RURAL TERTIARY CARE HOSPITAL

2021 ◽  
pp. 201-204
Author(s):  
Shashikantha Shashikantha ◽  
Sohil Sharda. ◽  
Bernice Robert ◽  
Gangurde Bhushan Daulatrao
Keyword(s):  
Acute Kidney Injury ◽  
Prognostic Factors ◽  
Renal Disease ◽  
Tertiary Care Hospital ◽  
Chronic Renal Disease ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Care Hospital ◽  
Study Results

INTRODUCTION: Acute kidney injury is a common occurrence in ICU admissions causing increased morbidity and mortality. Present study aimed to determine the causes and prognostic factors of acute kidney injury in intensive care unit. MATERIAL AND METHODS: This Hospital based Cross sectional Study was conducted at a tertiary care Hospital and Research Center, including 100 patients aged >18 years with Acute Kidney Injury admitted in ICU from the period of October 2018 to June 2020. Patients with chronic renal disease, previous renal transplantation, congenital renal disease were excluded from the study. RESULTS: Most of the patients (63%) were aged above 50 years. Diabetes was found in 55% and hypertension in 26% of AKI cases. Most common cause identied were sepsis, CLD, renal, CNS and CVD. Hypotension occurred in 48% patients, while oliguria occurred in 45% patients. Ventilatory support was required by 43% patients, while 31% patients required haemodialysis. Mortality rate in AKI was 51%. Mortality was signicantly associated with advanced age, presence of Diabetes, and RIFLE criteria. Spot urine <40 meq/L, hyperkalemia, serum creatinine >4 mg/dl, blood urea >100 mg/dl and acidosis were associated with higher mortality. CONCLUSION: Continuous monitoring parameters like Spot Fe Na, Serum Potasium and pH especially in patients at risk, like elderly patients with diabetes, those with sepsis, can help in early identication and appropiate management, thus reduce the incidence or severity of AKI.

P0643PROGNOSTIC IMPACT OF THROMBOCYTOPENIA IN THE RISK OF INTRAHOSPITAL BLEEDING IN ACUTE KIDNEY INJURY (AKI) PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Zorica Dimitrijevic ◽  
Branka Mitic ◽  
Danijela Tasic ◽  
Goran Paunovic ◽  
Karolina Paunovic ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Platelet Count ◽  
Major Bleeding ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Bleeding Risk ◽  
Prognostic Impact ◽  
Care Hospital ◽  
Ulcer Disease ◽  
Post Surgery

Abstract Background and Aims Low platelet count is a marker of adverse events in acute kidney injury (AKI) patients. Thrombocytopenia has often been reported as an indicator of underlying disease severity and worse patient outcomes; however, it’s role in the prediction of the risk of bleeding is not well defined. Our study aimed to assess the prognostic impact of admission thrombocytopenia in the risk of major bleeding in non-septic, non-post surgery AKI patients. Method This retrospective study enrolled patients with AKI hospitalized at tertiary care hospital during the three years. Admission thrombocytopenia was defined as a platelet count &lt; 150x103/mL. The primary endpoint was major bleeding, as defined by the International Society on Thrombosis and Haemostasis. Results Of 178 included patients (age 61.7±11.1 years; 68.3% males), 26 (14.6%) had thrombocytopenia. These patients had more comorbidities: cancer (19.4 vs 9.6%; p=0.05); previous ulcer disease (17.6 vs. 8.8; p=0.04) and bleeding history (7.4% vs. 2.0%;p=0.04). While in a hospital, there was a trend for the use of more blood transfusions (7.4% vs. 2.7%; p=0.03) and more concomitant medications (12.7 vs. 5.1; p&lt;0.05) in patients with thrombocytopenia. During a hospital stay (IQR: 7-29 days), 19 patients (10.7%) died), 22 (12.35%) had major bleeding, and 5 (2.8%) intracranial bleeding. After adjusting for age, presence of cancer, and use of oral anticoagulant medications, patients with thrombocytopenia had a higher risk of major bleeding (HR 3.34 95%CI: 1.57-7.26; p &lt; 0.001). Conclusion Thrombocytopenia is a predictor of major intrahospital bleeding in the non-septic, non-post surgery AKI patients. It should be regarded in bleeding risk estimation and therapeutic strategy decisions.

scholarly journals Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

2017 ◽  
Vol 6 (7) ◽  
pp. 2997
Author(s):  
Molina U. Patel ◽  
Yuvraj Jadeja ◽  
Niket Patel ◽  
Nayana Patel ◽  
Smruti Vaishnav ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

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