scholarly journals The risk factors and outcome of early identified acute kidney injury among critically ill obstetric patients

2017 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Amal Abd El-Hafez1 ◽  
Asmaa Mahjoub ◽  
Eman Ahmad

Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy and postpartum period that facing critical care nurses in Intensive Care Unit (ICU). Having a uniform standard for identifying and classifying AKI would enhance critical care nurses’ ability to recognize these patients and leading to better outcomes.Objective: This work aimed to explore the risk factors and outcome of early identified acute kidney injury of critically obstetric patients in Obstetric ICU. Design. A descriptive cross sectional research design was used in this study. Participants: A total sample of 338 women admitted to Obstetric ICU at Woman Health Hospital, Assiut City, Egypt. Method: Three tools were used.Tool I was developed by the researcher and included demographic and obstetric history, lab parameters, complications and outcomes arising from AKI. The Sequential Organ Failure Assessment (SOFA) score as tool II to determine the extent of a patient's organ function or rate of failure. Measurement of serum creatinine and urine output were used to early identify AKI stages according to Acute Kidney Injury Network (AKIN) Criteria (tool III). Results: The prevalence of AKI among obstetric patients admitted to obstetric ICU was 10.1%; of them 52.9% needed renal replacement therapy and the mortality rate was 29.4%. Postpartum hemorrhage was the most common cause of AKI and its prevalence was 41.2%. It was also found that 74.5% of AKI patients developed complications. Conclusion: AKI complicated 10.1% of total admitted women to the OICU in the studied period. Postpartum hemorrhage represents the most prevalent risk factors with a highly significant SOFA score compared to other risk factors as sever preeclampsia, eclampsia, HEELP & APH with acute fatty liver.

2018 ◽  
Vol 55 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Raimundo Martins GOMES JUNIOR ◽  
Lia Cavalcante CEZAR ◽  
Gdayllon Cavalcante MENESES ◽  
Geraldo Bezerra da SILVA JUNIOR ◽  
José Huygenes Parente GARCIA ◽  
...  

ABSTRACT BACKGROUND: Acute kidney injury (AKI) is a common complication in the immediate postoperative period of patients undergoing liver transplantation. OBJECTIVE: The aim of this study was to evaluate preoperative risk factors for AKI after liver transplantation. METHODS: A cross-sectional study was conducted with adults submitted to orthotopic liver transplantation at a reference hospital in Fortaleza, Northeast of Brazil, from January to December 2016. Preoperative risk factors were evaluated for AKI development in the immediate postoperative period. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. RESULTS: A total of 40 patients were included in the study. AKI was found in 85% of patients in the first 24 hours after transplantation, most of them (40%) classified in KDIGO stage 1. Preoperative data indicate that serum albumin levels were lower in the KDIGO stage 3 group compared to the non-AKI group, as well as the hematocrit levels. Direct bilirubin (DB) was higher in the KDIGO stage 3 group compared to the group without AKI, as well as alkaline phosphatase (AP) and gamma-glutamiltransferase (GGT). In a logistic regression analysis independent risk factors for AKI were increase levels of AP, GGT and DB and decrease level of serum albumin. CONCLUSION: Low levels of serum albumin, and elevated levels of DB, AP and GGT in the preoperative period are risk factors for AKI development after liver transplantation.


2021 ◽  
Vol 7 (1) ◽  
pp. 42-46
Author(s):  
Sharmin Akter Luna ◽  
Jakia Sultana ◽  
Abdullah Al Mamun ◽  
Afroza Begum ◽  
Md Habibur Rahman ◽  
...  

Background: Acute kidney injury can occur among the younger children due to different reasons. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among younger children. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology with the collaboration of Paediatric Gastroenterology, Paediatric Neurology, Paediatric Neonatology and Microbiology and Immunology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of 1 month to 17 years who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 42 patients, who fulfilled the inclusion criteria were enrolled in this study. The risk factors of AKI was mainly pre renal in 60% (n=9) cases, mostly due to nephrotoxic drugs followed by hypovolemia. Renal causes were in 40% (n=6) cases. Among these 50% cases due to amikacin and 50% cases due to use of radiocontrast agent. Most patients were with renal disease which was 30(58%) cases. Among them 28(93.0%) cases were nephrotic syndrome and 2(7.0%) cases were hydronephrosis. However, 7(13%) cases were cardiac disease presented with congenital heart disease who used radiocontrast agent. Conclusion: In conclusion most common risk factors of acute kidney injury among younger children is pre-renal causes which are due to nephrotoxic drugs. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 42-46


2017 ◽  
Vol 11 (2) ◽  
pp. 47-49
Author(s):  
Swapan Kumar Mondal ◽  
Bablu Kumar Paul ◽  
Shubharthi Kar ◽  
Swapan Kumar Biswas ◽  
Zebunnesa Parvin ◽  
...  

Acute kidney injury (AKI) occurs in approximately 1-7% of all hospitalized patients. Those patients undergo major surgical procedures are at high risk for AKI due to high volume blood loss, electrolytes disturbance, development of preoperative infection or sepsis and presence of several co-morbidities that may impair renal function. However, published data on postoperative kidney injury are scarce outside the cardiovascular surgery setting. Therefore the study was designed to find out the incidence and risk factors of postoperative acute kidney injury in non-cardiac major surgery. A cross-sectional observational study was conducted in the department of nephrology, BSMMU, Dhaka from January 2014 to December 2014. In this study we found the overall incidence of postoperative AKI 6%. Among the risk factors-male sex, increased age, lengthy operation, exposure to general anesthesia, perioperative hypotension, blood transfusion and use of nephrotoxic drugs (NSAIDs, Aminoglycosides) are important.Faridpur Med. Coll. J. Jul 2016;11(2): 47-49


2020 ◽  
Vol 17 (2) ◽  
pp. 21-27
Author(s):  
Parag Karki ◽  
Arun Maskey ◽  
Birat Krishna Timalsena ◽  
Samir Kumar Poudel ◽  
Binayak Gautam ◽  
...  

Background and Aims: ACEF score is simple risk score which uses only three parameters for predicting mortality and postcontrast acute kidney injury (PC-AKI). This study was designed to look into various risk factors and ACEF score for patients undergoing Percutaneous Coronary Intervention (PCI). Methods: This is single-centre, observational, cross-sectional study. The patients were divided into tertiles.Bivariate analysis of various risk factors and ACEF score was done for PC-AKI as well as In-hospital and 30-day mortality. Results: Total 257 patients were included.The total mortality among PCI patients were low: In-hospital (0.8%) and 30-day (1.9%). The risk factor for increased mortality were higher Killip class and reduced Ejection Fraction (EF). PCAKI occurred in one-fifth. The risk factors for PC-AKI were increasing age, higher Killip class, diabetes, reduced EF, emergency PCI procedure and higher contrast volume. Hydration with NS was protective against PC-AKI. Mean ACEF score was higher among those who died within 30 days (p=0.35) and who developed PC-AKI (p<0.001). ACEF-low had trend toward better outcome with no mortality (p=0.17) and had low risk of PC-AKI (p=0.026). ACEF-moderate had reduced risk of PC-AKI (p=0.029), however was not associated with increased odds of 30-day mortality (p=0.66). ACEF-high showed significantly increased odds of mortality (p=0.04) and PC-AKI (p<0.001). Discriminatory capacity of ACEF score to detect 30-day mortality was good (AUC 0.82, p= 0.016) and goodness of fit=0.70. Discriminatory capacity of ACEF score to detect PC-AKI was fair (AUC 0.7, p<0.001) and goodness of fit=0.62. Conclusions: ACEF score fairly predicts the short-term mortality and PC-AKI in patients undergoing PCI.


Renal Failure ◽  
2016 ◽  
Vol 38 (9) ◽  
pp. 1413-1417 ◽  
Author(s):  
Qing Wei ◽  
Hong Liu ◽  
Yan- Tu ◽  
Ri-Ning Tang ◽  
Yan-Li Wang ◽  
...  

2019 ◽  
Vol 8 (1) ◽  
pp. 12-18
Author(s):  
Nitai Chandra Ray ◽  
Md Ayub Ali Chowdhury ◽  
Md Abdul Muqeet ◽  
Mahmud Javed Hasan ◽  
Ashutosh Saha Roy ◽  
...  

Acute kidney injury (AKI) is a common complication after acute stroke. Multiple additional risk factors are also responsible for development of AKI during acute stroke. This cross sectional observational study was conducted with a total of 240 newly detected computed tomography (CT) confirmed acute stroke patients in Mymensingh Medical College Hospital with an aim to find out the incidence and risk factors of AKI in acute stroke. In this study, AKI developed in 15.42% of all types of acute stroke and more commonly in haemorrhagic stroke than in ischaemic stroke (23.44% vs. 12.50%, P<0.05). AKI was found more frequently (54.05%) in old >60 years age group and in male patients(17.93% vs. 11.58% & P>0.05). Again, AKI developed most commonly in chronic kidney disease (CKD) (33.33%, P<0.05) and then in diabetes mellitus (DM) (31.03%, P<0.05), in ischaemic heart disease (IHD) (28.11%, P<0.05), in hypertension (21.14%, P<0.05), in previous stroke (15.22%, P>0.05), in dyslipidaemia (13.33%, P>0.05), and in smoker (9.89%, P>0.05). Family history of (H/O) DM was present in 30.00% (P>0.05) and that of hypertension and kidney disease was present in 24.44% (P>0.05) and 25.00% (P>0.05) of stroke patients, respectively. Among the AKI patients, majority (70.27%) had hypertension and 37.84% had CKD, 29.73% had IHD. DM and smoker were 24.32%of each. Family H/O of hypertension, DM and kidney disease was present in 29.73%, 16.22% & 13.51 % of AKI patients, respectively. So, this study had identified several important risk factors of AKI, in particular age, sex, smoking, hypertension, DM, IHD, CKD and types of stroke. So, the risk score could be easily calculated to predict the risk of AKI in stroke patients. And thus to prevent the development of AKI is of utmost importance to reduce the related morbidity and mortality of acute stroke patients. A multicenter nationwide intensive research is needed to identify the precise mechanism, risk factors, their relation and actual outcome of AKI that develop in patients with acute stroke. CBMJ 2019 January: vol. 08 no. 01 P: 12-18


2021 ◽  
Vol 9 (F) ◽  
pp. 118-123
Author(s):  
Dian Daniella ◽  
Yenny Kandarini ◽  
Gede Wira Mahadita

BACKGROUND: Acute kidney injury (AKI) in coronavirus disease-19 (COVID-19) has high incidence and mortality. Risk factors for AKI in COVID-19 patients are not well explored. This systematic review provides a combination of available evidence regarding risk factors of AKI in COVID-19 patients. METHODS: A systematic research was performed in Medline, Cochrane Central Register of Controlled Trials, and ScienceDirect journal databases from 2019 to August 2020. The study selection process was plotted using a Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. RESULTS: Out of 553 studies found, four full-text studies met the inclusion criteria and were included in qualitative analysis. There are 2205 COVID-19 patients with AKI (36.44%) from 6051 COVID-19 patients. Age was a risk factors for AKI in two studies (odds ratio [OR] 1.03 [p < 0.001], OR 1.03 [p < 0.007]). Critical condition of patient is risk factors for AKI (OR 8.155 [p = 0.006]). Hirsch et al. stated that diabetes mellitus (OR 1.74 [p < 0.001]), cardiovascular disease (OR 1.48 [p < 0.001]), and hypertension (OR 1.25 [p = 0.02]) are also risk factors. Laboratory results such as elevated procalcitonin (PCT) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 showed positive association to AKI in COVID-19 patients (OR 4.822 [p = 0.037]; OR 13.451 [p = 0.016]). A higher sequential organ failure assessment (SOFA) score at admission is one of the risk factors (OR 1.498 [p = 0.027]). CONCLUSION: Demographics, clinical classification of COVID-19, comorbidities, SOFA score, PCT, and eGFR can help clinicians predict AKI in COVID-19 patients.


2020 ◽  
Vol 9 (1) ◽  
pp. 21-24
Author(s):  
Abhishek Maskey ◽  
Ram Chandra Kafle ◽  
Sudip Lamsal

Background and Aims: Coronary angiography/ interventions depend on iodinated contrast media (CM) and consequently pose risk of contrast-induced acute kidney injury (CI-AKI). This is an important complication that accounts for a significant number of cases of hospital-acquired kidney injury, with adverse effects on prognosis and health care. This study aimed to assess incidence and evaluate risk factor CI-AKI associated with diagnostic or interventional coronary angiography. Methods: A prospective cross sectional observational hospital based study was conducted. All patients undergoing percutaneous coronary angiography in Manipal Teaching Hospital from May 1, 2019 to April 31, 2020 were included in this study. Appropriate statistical tests were used to analyse results and P <0.05 was considered statistically significant. Results: We evaluated a total of 155 patients. Among them, 90 (58%) were male and 65 (42%) female. The mean age of patients was 62.74 ± 13.9 years. Overall incidence of contrast induced acute kidney injury was 15.48%. CI-AKI was observed to be more common in patient with advance age and diabetes. Apart from advance age and diabetes, none of the other conventional risk factors such as hypertension, anaemia, volume of contrast, baseline chronic kidney disease found to have a significant association with incidence of CI-AKI. None of the patients in our study required renal replacement therapy, and there was no mortality. Conclusion: The overall incidence of CI-AKI after coronary intervention in this study is high. Patients with advance age and diabetes were at high risk of CI-AKI.


2021 ◽  
Vol 8 (1) ◽  
pp. 12-16
Author(s):  
Sharmin Akter Luna ◽  
Syma Akter ◽  
Tahmina Jesmin ◽  
Syed Saimul Haque ◽  
Golam Muin Uddin ◽  
...  

Background: There are several risk factors and diseases related with the acute kidney injury among neonates. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among neonates. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of less than 1 months who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 52 patients who fulfilled the inclusion criteria were enrolled in this study. Among them 10 cases were in neonatal age group. The mean age was 10.8±5.4 days with female predominance. The risk factors of AKI in neonate was only pre-renal; mostly due to hypovolemia which was 3(60.0%) cases followed by sepsis and asphyxia which were 1(20.0%) case in each. The most patients had sepsis which was 4(40.0%) cases followed by congenital heart disease which was 2(20.0%) cases; one presented with heart failure and another one had cyanotic congenital heart disease. Conclusion: In conclusion hypovolemia, sepsis and asphyxia are the most common risk factors of acute kidney injury among the neonates. Journal of Current and Advance Medical Research, January 2021;8(1):12-16


2020 ◽  
Vol 4 (1) ◽  
pp. 10-18
Author(s):  
Foroogh Sabzghabaei ◽  
Vahid Mahmoodi ◽  
Masoume Pouladi ◽  
Zeynab Yassin ◽  
parnian soltani ◽  
...  

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