MP234PREDICTIVE VALUE OF CHRONIC KIDNEY DISEASE (CKD) IN ACUTE KIDNEY INJURY (AKI) PRESENTATION IN AN INTENSIVE CARE UNIT (ICU) OF A LOCAL HOSPITAL

ABSTRACT Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

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Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Neurocritical Care

Journal of Intensive Care Medicine ◽

10.1177/0885066617748596 ◽

2018 ◽

Vol 35 (4) ◽

pp. 338-346 ◽

Cited By ~ 1

Author(s):

Stefan Büttner ◽

Andrea Stadler ◽

Christoph Mayer ◽

Sammy Patyna ◽

Christoph Betz ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Risk Factor ◽

Intensive Care ◽

Kidney Disease ◽

Neurocritical Care ◽

Kidney Injury ◽

Prognostic Impact ◽

Incidence Risk

Purpose: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. Methods: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2). Results: The study population comprised 681 neurocritically ill patients from a mixed neurosurgical and neurological intensive care unit. The prevalence of chronic kidney disease (CKD) was 8.4% (57/681). Overall incidence of AKI was 11.6% with 36 (45.6%) patients developing dialysis-requiring AKI. Sepsis was the main cause of AKI in nearly 50% of patients. Acute kidney injury and renal replacement therapy are independent predictors of worse outcome (hazard ratio [HR]: 3.704; 95% confidence interval [CI]: 1.867-7.350; P < .001; and HR: 2.848; CI: 1.301-6.325; P = .009). Chronic kidney disease was the strongest independent risk factor (odds ratio: 12.473; CI: 5.944-26.172; P < .001), whereas surgical intervention or contrast agents were not associated with AKI. Conclusions: Acute kidney injury in neurocritical care has a high incidence and is a crucial risk factor for mortality independently of the underlying neurocritical condition. Sepsis is the main cause of AKI in this setting. Therefore, careful prevention of infectious complications and considering CKD in treatment decisions may lower the incidence of AKI and hereby improve outcome in neurocritical care.

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Timing of renal replacement therapy and long-term risk of chronic kidney disease and death in intensive care patients with acute kidney injury

Critical Care ◽

10.1186/s13054-017-1903-y ◽

2017 ◽

Vol 21 (1) ◽

Cited By ~ 8

Author(s):

Søren Christiansen ◽

Steffen Christensen ◽

Lars Pedersen ◽

Henrik Gammelager ◽

J. Bradley Layton ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Kidney Disease ◽

Replacement Therapy ◽

Kidney Injury ◽

Intensive Care Patients

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The Role of Nephrologist in the Intensive Care Unit

Blood Purification ◽

10.1159/000452318 ◽

2016 ◽

Vol 43 (1-3) ◽

pp. 78-81 ◽

Cited By ~ 4

Author(s):

Zoltán H. Endre

Keyword(s):

Chronic Kidney Disease ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Kidney Injury ◽

Renal Diseases ◽

Continuing Care ◽

Electrolyte Disorders

Participation by nephrologists is needed in most intensive care units, even when such units are ‘closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile. Management of AKI by intensivists should be in partnership with nephrologists to oversight and hopefully to minimize progression to CKD.

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Outcomes of adults with congenital heart disease that experience acute kidney injury in the intensive care unit

Cardiology in the Young ◽

10.1017/s1047951120003923 ◽

2020 ◽

pp. 1-5

Author(s):

Dana Y. Fuhrman ◽

Lan Nguyen ◽

Emily L. Joyce ◽

Priyanka Priyanka ◽

John A. Kellum

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Congenital Heart Disease ◽

Young Adults ◽

Intensive Care ◽

Kidney Disease ◽

Renal Dysfunction ◽

Congenital Heart ◽

Kidney Injury ◽

Acute Kidney Disease

Abstract Background: Young adults with congenital heart disease (CHD) are increasing in number with an increased risk for acute kidney injury. Little is known concerning the impact of non-recovery of kidney function for these patients. Therefore, we sought to explore the rates of acute kidney disease, persistent renal dysfunction, and their associations with adverse outcomes in young adults with CHD. Methods: This is a single-centre retrospective study including all patients at the ages of 18–40 with CHD who were admitted to an intensive care unit between 2010 and 2014. Patients with a creatinine ≥ 1.5 times the baseline at the time of hospital discharge were deemed to have persistent renal dysfunction, while acute kidney disease was defined as a creatinine ≥ 1.5 times the baseline 7–28 days after a diagnosis of acute kidney injury. Outcomes of death at 5 years and length of hospital stay were examined using multivariable logistic regression and negative binomial regression, respectively. Results: Of the (89/195) 45.6% of patients with acute kidney injury, 33.7% had persistent renal dysfunction and 23.6% met the criteria for acute kidney disease. Persistent renal dysfunction [odds ratio (OR), 3.27; 95% confidence interval (CI): 1.15–9.29] and acute kidney disease (OR: 11.79; 95% CI: 3.75–39.09) were independently associated with mortality at 5 years. Persistent renal dysfunction was associated with a longer duration of hospital stay (Incidence Rate Ratio: 1.96; 95% CI: 1.53–2.51). Conclusions: In young adults with CHD, acute kidney injury was common and persistent renal dysfunction, as well as acute kidney disease, were associated with increased mortality and length of hospitalisation.

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Serum and Urine Neutrophil Gelatinase-Associated Lipocalin Levels Measured at Admission Predict Progression to Chronic Kidney Disease in Sepsis-Associated Acute Kidney Injury Patients

Disease Markers ◽

10.1155/2020/8883404 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Pham Ngoc Huy Tuan ◽

Dao Bui Quy Quyen ◽

Huynh Van Khoa ◽

Nguyen Duc Loc ◽

Pham Van My ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury ◽

Urine Ngal ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Admission Time ◽

Neutrophil Gelatinase ◽

Serum And Urine

Background. To evaluate the ratio of acute kidney injury (AKI) to chronic kidney disease (CKD) in sepsis-associated acute kidney injury (SA-AKI) patients of the intensive care unit (ICU) and predictive value of neutrophil gelatinase-associated lipocalin (NGAL) measured at the admission time in the progression of AKI to CKD. Methods. A study of 121 consecutive adult patients admitted to the intensive care unit (ICU) diagnosed as SA-AKI. AKI and CKD were defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Glomerular filtration rate (GFR) was calculated by the CKD-EPI formula. Serum and urine NGAL was measured using the BioVendor Human Lipocalin-2/NGAL ELISA with a blood sample taken at hospital admission time. Results. The ratio of AKI to CKD in SA-AKI patients was 22.3%. Mean concentration of serum and urine NGAL in AKI to the CKD group was 790.99 ng/ml and 885.72 ng/ml, higher significantly than those of recovery patients (351.86 ng/ml and 264.68 ng/ml), p<0.001. eGFR, both serum and urine NGAL had a predictive value for AKI to CKD (eGFR: AUC=0.857, Se=74.1%, Spe=92.6%, p<0.001. Serum NGAL: AUC=0.868, Se=77.8%, Spe=91.5%. Urine NGAL: AUC=0.869, Se=77.8%, Spe=92.6%, p<0.001. Conclusion. Serum and urine NGAL, measuring at hospital admission time, were good prognostic biomarkers of AKI to CKD in SA-AKI patients.

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