scholarly journals Acute Kidney Injury Outcomes of Elderly and Nonelderly Patients in the Medical Intensive Care Unit of a University Hospital in a Developing Country

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wanjak Pongsittisak ◽  
Kashane Phonsawang ◽  
Solos Jaturapisanukul ◽  
Surazee Prommool ◽  
Sathit Kurathong
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Medical Intensive Care Unit ◽  
Kidney Injury ◽  
The Elderly ◽  
University Hospital ◽  
Medical Intensive Care

Background. Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI. In this study, we compared AKI outcomes between elderly and nonelderly patients in a university hospital in a developing country. Materials and Methods. This retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. The patients were divided into the elderly (eAKI; age ≥65 years; n = 158) and nonelderly (nAKI; n = 142) groups. Baseline characteristics, comorbidities, principle diagnosis, renal replacement therapy (RRT) requirement, hospital course, and in-hospital mortality were recorded. The primary outcome was in-hospital mortality. Results. The eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. The etiology and staging of AKI were similar between the two groups. There were no significant differences in in-hospital mortality (p=0.338) and RRT requirement (p=0.802) between the two groups. After adjusting for covariates, the 28-day mortality rate was similar between the two groups (p=0.654), but the 28-day RRT requirement was higher in the eAKI group than in the nAKI group (p=0.042). Conclusion. Elderly and nonelderly ICU patients showed similar survival outcomes of AKI, although the elderly were at a higher risk of requiring RRT.

scholarly journals CLINICAL PROFILE OF ACUTE KIDNEY INJURY PATIENTS ADMITTED IN MEDICAL INTENSIVE CARE UNIT IN TERTIARY CARE CENTRE

2019 ◽  
pp. 1-3
Author(s):  
Manisha Netam ◽  
R. S. Jagat ◽  
Nitin Nahar*
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Common Causes ◽  
Patient Load ◽  
Medical Intensive Care ◽  
Morbid Conditions

Acute kidney injury is one of the major conditions complicating the outcome of hospital admitted patients. Early detection and treatment of AKI can help reduce the mortality to a signicant level. The most common conditions succumbing to AKI are hypovolemia, sepsis, drug induced kidney injury, cardiac conditions (reduced cardiac output). Common co-morbid conditions associated are hypertension, diabetes, chronic debilitating conditions like CVA and CAD. OBJECTIVE- The study aimed at evaluating the etiological factors and co-morbid conditions associated with acute kidney injury in medical intensive care unit in tertiary care setting in central India. MATERIAL AND MATERIAL AND METHODS- Total 200 patients admitted in medical ICU were selected based on AKIN criteria. pre-exiting conditions like hypertension, diabetes, CAD, CVA were noted. Increase in serum creatinine >1.5 times or >0.3mg/dl and decrease in urine output <0.5ml/kg/h for 6-12 hrs were the criteria for selection. Patients were observed till the time of discharge or death. Data collected was analysed statistically. RESULTS-Out of the 200 enrolled in the study,81 patients were female and 119 males. Majority of the patients were found to be under the age group of 35-54 years with a total number of 101. Hypertension was found to be the major co-morbid condition with a patient load of 62, followed by diabetes, CVA, CAD with a patient load of 30,24and 5 respectively. Sepsis and shock were found to complicating majority of the illnesses and contributing 87.6% and 67.6% to the total mortality. Infective conditions like acute gastroenteritis and UTI were the most common causes with a total load of 76 and 15 respectively. Chronic liver disease and hemolytic conditions like malaria were found to contributing a lower patient load but higher mortality. Other causes found to be associated with AKI were found to be post natal cases, snake bite and poisoning. CONCLUSION- pre- renal causes were found to be the most common causes of AKI. Early recognition and vigorous management is the key to reduce mortality and long term complications

scholarly journals Association of Prior to Intensive Care Unit Statin Use With Outcomes on Patients With Acute Kidney Injury

2021 ◽  
Vol 8 ◽  
Author(s):  
Boxiang Tu ◽  
Yuanjun Tang ◽  
Yi Cheng ◽  
Yuanyuan Yang ◽  
Cheng Wu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Mortality Rate ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Icu Mortality ◽  
Propensity Score Methods ◽  
Statin Use

Purpose: To evaluate the association of prior to intensive care unit (ICU) statin use with the clinical outcomes in critically ill patients with acute kidney injury (AKI).Materials and Methods: Patients with AKI were selected from the Medical Information Mart for Intensive Care IV (version 1.0) database for this retrospective observational study. The primary outcome was 30-day intensive care unit (ICU) mortality. A 30-day in-hospital mortality and ICU length of stay (LOS) were considered as secondary outcomes. Comparison of mortality between pre-ICU statin users with non-users was conducted by the multivariate Cox proportional hazards model. Comparison of ICU LOS between two groups was implemented by multivariate linear model. Three propensity score methods were used to verify the results as sensitivity analyses. Stratification analyses were conducted to explore whether the association between pre-ICU statin use and mortality differed across various subgroups classified by sex and different AKI stages.Results: We identified 3,821 pre-ICU statin users and 9,690 non-users. In multivariate model, pre-ICU statin use was associated with reduced 30-day ICU mortality rate [hazard ratio (HR) 0.68 (0.59, 0.79); p &lt; 0.001], 30-day in-hospital mortality rate [HR 0.64 (0.57, 0.72); p &lt; 0.001] and ICU LOS [mean difference −0.51(−0.79, −0.24); p &lt; 0.001]. The results were consistent in three propensity score methods. In subgroup analyses, pre-ICU statin use was associated with decreased 30-day ICU mortality and 30-day in-hospital mortality in both sexes and AKI stages, except for 30-day ICU mortality in AKI stage 1.Conclusion: Patients with AKI who were administered statins prior to ICU admission might have lower mortality during ICU and hospital stay and shorter ICU LOS.

scholarly journals Impact of Prior to Intensive Care Unit Statin use on Patients with Acute Kidney Injury

2021 ◽  
Author(s):  
Bo-Xiang Tu ◽  
Yuan-Jun Tang ◽  
Yi Cheng ◽  
Xiao-Bin Liu ◽  
Cheng Wu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Mortality Rate ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Icu Mortality ◽  
Propensity Score Methods ◽  
Statin Use

Abstract Purpose: To evaluate if prior to intensive care unit (ICU) statin use improve the clinical outcomes, for critically ill patients with acute kidney injury (AKI).Materials and Methods: Patients with AKI were selected from the Medical Information Mart for Intensive Care IV v1.0 database for this retrospective observational study. The primary outcome was 30-day ICU mortality. 30-day in-hospital mortality and ICU length of stay (LOS) were considered as secondary outcomes. Comparison of mortality between pre-ICU statin users with non-users was conducted by multivariable cox proportional hazards model. Comparison of ICU LOS between two groups was implemented by multivariable linear model. Three propensity score methods were used to verify the results as sensitivity analyses. Stratification analyses were conducted to explore whether the association between pre-ICU statin use and mortality differed across various subgroups classified by sex and different AKI stages.Results: 3821 pre-ICU statin users and 9690 non-users were identified. In multivariable model, pre-ICU statin use was associated with reduced 30-day ICU mortality rate [Hazara ratio (HR) 0.68 (0.59,0.79); P<0.001], 30-day in-hospital mortality rate [HR 0.64 (0.57, 0.72); P<0.001] and ICU LOS [Mean Difference -0.51(-0.79, -0.24); P<0.001]. The conclusions were consistent in three propensity score methods. In Subgroup analyses, pre-ICU statin use was associated with decreased 30-day ICU mortality and 30-day in-hospital mortality in both sexes and AKI stages, only except for 30-day ICU mortality in AKI stage 1.Conclusions: Patients with AKI who were administered statins prior to ICU admission might have lower mortality rate during ICU or hospital stay and shorter ICU LOS.

scholarly journals ETIOLOGICAL FACTORS AND CLINICAL PROFILE OF ACUTE KIDNEY INJURY IN MICU

2019 ◽  
Vol 2 (11) ◽  
Author(s):  
Mekha K Mathew ◽  
Radha
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Management Practices ◽  
Medical Intensive Care Unit ◽  
Kidney Injury ◽  
Febrile Illness ◽  
Study Group ◽  
Ventilator Support ◽  
Medical Intensive Care

Background and Objectives Data on the etiology, management practices and outcome in patients admitted to intensive care units in Kerala has not been studied in depth. The etiology and patterns of AKI, as well as management practices are likely to differ in countries with resource limitations and variations in disease patterns. The present study was undertaken to identify the etiologic factors and outcome of patients with Acute Kidney Injury admitted in Medical ICU. Methods The study is a cross sectional study, done in 150 consecutive patients admitted to Medical Intensive Care Unit, Government Medical College, Kottayam meeting the AKIN creatinine criteria for acute kidney injury over a period of 12 months. Results and Discussion The most common diagnosis in the patients admitted with AKI in MICU was Leptospirosis (22%) followed by undifferentiated fever (21%) and sepsis seen in 17%. Dialysis was required in 81.3% among those with undifferentiated febrile illness and 78.8% among those with leptospirosis. Significant association was identified between etiology of AKI and the need for dialysis. The most common stage of AKI in the patients in this study group on admission to the medical intensive care unit was stage 3 in 64.7%. 45% of the patients required dialysis, among which 24% underwent CRRT while the 76% underwent hemodialysis. Out of 150 cases 59% survived and 41% expired. Mortality was more in the patients in this study with undifferentiated acute febrile illness, 43.8% and leptospirosis, 36.4%. Mortality was 48.5% in those who underwent dialysis. But no significant association was identified between requirement of dialysis or diagnosis and mortality. Significant association was identified between patients with breathlessness, basal crepitations, later stage of AKI, inotropic support, ventilator support and mortality with p value <0.05. By logistic regression analysis of the factors having association with mortality, requirement of ventilator support and inotropic supports were independent predictors of mortality. Conclusion The most common etiology was leptospirosis (22%) followed by undifferentiated fever (21%). Mortality was 41% in the patients in the study group. Requirement of ventilator support and inotropic supports were independent predictors of mortality.

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