scholarly journals National trends in age-standardized incidence and mortality rates of acute kidney injury in Peru

2020 ◽  
Vol 42 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Percy Herrera-Añazco ◽  
Maycol Suker Ccorahua-Ríos ◽  
Mirian Condori-Huaraka ◽  
Yerika Huamanvilca-Yepez ◽  
Elard Amaya ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Secondary Data ◽  
Mortality Rates ◽  
Epidemiological Studies ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Incidence And Mortality ◽  
National Trends

ABSTRACT Introduction: Acute kidney injury (AKI) is a common disorder that causes high healthcare costs. There are limited epidemiological studies of this disorder in low- and middle-income countries. The aim of this study was to describe trends in the age-standardized incidence and mortality rates of AKI in Peru. Methods: We conducted an ecological study based on a secondary data sources of the basic cause of death from healthcare and death records obtained from establishments of the Ministry of Health of Peru for the period 2005-2016. The age-standardized incidence and mortality rates of AKI were described by region and trend effects were estimated by linear regression models. Results: During the period 2005-2016, 26,633 cases of AKI were reported nationwide. The age-standardized incidence rate of AKI per 100,000 people increased by 15.2%, from 10.5 (period 2005-2010) to 12.1 (period 2011-2016). During the period 2005-2016, 6,812 deaths due to AKI were reported, which represented 0.49% of all deaths reported for that period in Peru. The age-standardized mortality rate of AKI per 100,000 people decreased by 11.1%, from 2.7 (period 2005-2010) to 2.4 (period 2011-2016). The greatest incidence and mortality rates were observed in the age group older than 60 years. Conclusions: During the study period, incidence of AKI increased and mortality decreased, with heterogeneous variations among regions.

scholarly journals Predictors of mortality in children with acute kidney injury in intensive care unit

2019 ◽  
Vol 59 (2) ◽  
pp. 92-7
Author(s):  
Umi Rakhmawati ◽  
Indah K. Murni ◽  
Desy Rusmawatiningtyas
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Protective Factor ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Middle Income ◽  
Predictors Of Mortality ◽  
Middle Income Countries

Background Acute kidney injury (AKI) can increase the morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Previous published studies have mostly been conducted in high-income countries. Evaluations of possible predictors of mortality in children with AKI in low- and middle-income countries have been limited, particularly in Indonesia. Objective To assess possible predictors of mortality in children with AKI in the PICU. Methods We conducted a retrospective cohort study at Dr. Sardjito Hospital, Yogyakarta, Indonesia. All children with AKI admitted to PICU for more than 24 hours from 2010 to 2016 were eligible and consecutively recruited into the study. Logistic regression analysis was used to identify independent predictors. Results Of the 152 children with AKI recruited, 119 died. In order to get a P value of <0.25, multivariate analysis is run to degree AKI, ventilator utilization, primary infection disease, MOF and age.Multivariate analysis showed that ventilator use, severe AKI, and infection were independently associated with mortality in children with AKI, with odds ratios (OR) of 19.2 (95%CI 6.2 to 59.7; P<0.001), 8.6 (95%CI 2.7 to 27.6; P<0.001), and 0.2 (95%CI 0.1 to 0.8; P=0.02), respectively. Conclusion The use of mechanical ventilation and the presence of severe AKI are associated with mortality in children with AKI admitted to the PICU. Interestingly, the presence of infection might be a protective factor from mortality in such patients. 

scholarly journals Acute Kidney Injury in Poor Countries Should No Longer Be a Death Sentence: The ISN ‘0 by 25' Project

2015 ◽  
Vol 66 (Suppl. 3) ◽  
pp. 42-44 ◽  
Author(s):  
Norberto Perico ◽  
Giuseppe Remuzzi
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Death Sentence ◽  
Public And Private ◽  
Middle Income ◽  
Poor Countries ◽  
The Public ◽  
Middle Income Countries ◽  
Timely Fashion

Acute kidney injury (AKI) is a common disorder throughout the world that is associated with severe morbidity, mortality and cost. Although deaths due to AKI occur in both high- and low- and middle-income countries (LMIC), the majority of avoidable deaths occur in LMIC nations. If managed adequately and in a timely fashion, the majority of these cases of AKI are preventable, treatable and often reversible with simple measures. AKI also has a major economic impact on healthcare expenditure. This is particularly true in poor countries where AKI especially impacts young productive people, imposing severe penury on their families. The International Society of Nephrology (ISN) has launched a long-term program, the ‘0 by 25' project, which advocates that zero people should die of untreated AKI in the poorest part of Africa, Asia and Latin America by 2025. The mission is to eventually lessen the high burden in terms of deaths consequent to this disorder in resource-poor regions worldwide. This is a challenging but potentially feasible and productive initiative that requires a broad vision about how the public and private sectors can work in partnership with the governments of the LMIC countries and leading nongovernmental organizations operating locally, to ensure sustainability of the 0 by 25 program and save many lives.

scholarly journals 1659. Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Clinical Data and Impact on Hospital Outcome Comparisons

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S49-S50 ◽  
Author(s):  
Chanu Rhee ◽  
Maximilian Jentzsch ◽  
Sameer S Kadri ◽  
Christopher Seymour ◽  
Derek Angus ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Organ Dysfunction ◽  
Clinical Data ◽  
Hepatic Injury ◽  
Claims Data ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Administrative Claims ◽  
Sepsis Mortality ◽  
Incidence And Mortality

Abstract Background Administrative claims data are commonly used for sepsis surveillance, research, and quality improvement. However, variations in diagnosis, documentation, and coding practices may confound efforts to benchmark hospital sepsis outcomes using claims data. Methods We evaluated the sensitivity of claims data for sepsis and organ dysfunction relative to clinical data from the electronic health records of 193 US hospitals. Sepsis was defined clinically using markers of presumed infection (blood cultures and antibiotic administrations) and concurrent organ dysfunction. Organ dysfunction was measured using laboratory data (acute kidney injury, thrombocytopenia, hepatic injury), vasopressor administrations (shock), or mechanical ventilation (respiratory failure). Correlations between hospitals’ sepsis incidence and mortality rates by claims (using “explicit” ICD-9-CM codes for severe sepsis or septic shock) versus clinical data were measured by the Pearson correlation coefficient (r) and relative hospital rankings using either data source were compared. All estimates were reliability-adjusted to account for random variation using hierarchical logistic regression modeling. Results The study cohort included 4.3 million adult hospitalizations in 2013 or 2014. The sensitivity of hospitals’ claims data for sepsis and organ dysfunction was low and variable: median sensitivity 30% (range 5–54%) for sepsis, 66% (range 26–84%) for acute kidney injury, 39% (range 16–60%) for thrombocytopenia, 36% (range 29–44%) for hepatic injury, and 66% (range 29–84%) for shock (Figure 1). There was only moderate correlation between claims and clinical data for hospitals’ sepsis incidence (r = 0.64) and mortality rates (r = 0.61), and relative hospital rankings for sepsis mortality differed substantially using either method (Figure 2). Of 48 (46%) hospitals, 22 ranked in the lowest sepsis mortality quartile by claims shifted to higher mortality quartiles using clinical data. Conclusion Variation in the completeness and accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospital sepsis rates and outcomes. Sepsis surveillance using objective clinical data may facilitate more meaningful hospital comparisons. Disclosures All authors: No reported disclosures.

scholarly journals Cervical Cancer in the Greater Accra and Ashanti Regions of Ghana

2017 ◽  
Vol 3 (6) ◽  
pp. 782-790 ◽  
Author(s):  
Yvonne Nartey ◽  
Philip C. Hill ◽  
Kwabena Amo-Antwi ◽  
Kofi M. Nyarko ◽  
Joel Yarney ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Tumor Grade ◽  
Mortality Rates ◽  
Teaching Hospitals ◽  
Middle Income ◽  
Middle Income Countries ◽  
Common Cancer ◽  
Incidence And Mortality ◽  
Low And Middle Income

Purpose Cervical cancer is a common cancer among women worldwide. An estimated 528,000 new cases and 266,000 deaths occurred in 2012. More than 85% of invasive cervical cancer cases occur in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. We conducted a retrospective study to assess the descriptive epidemiology of cervical cancer in Ghana. We describe cervical cancer incidence and mortality rates for the regions served by two large hospitals in Ghana. Patients and Methods Information for women diagnosed with invasive cervical cancer between 2010 and 2013 was collected from the Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, computer, and pathology records at the oncology units and the obstetrics and gynecology departments. Telephone interviews were also conducted with patients and relatives. Data were analyzed using summary statistics. Results A total of 1,725 women with cervical cancer were included in the study. Their ages ranged from 11 to 100 years (mean, 56.9 years). The histology of the primary tumor was the basis of diagnosis in 77.5% of women and a clinical diagnosis was made in 22.5% of women. For the 1,336 women for whom tumor grade was available, 34.3% were moderately differentiated tumors. Late stage at presentation was common. The incidence and mortality rates of cervical cancer increased with age up until the 75 to 79–year age group and began to decrease at older ages. The Greater Accra region had higher overall incidence and mortality rates than the Ashanti region. Conclusion Our study suggests that improvements in the application of preventive strategies could considerably reduce the burden of cervical cancer in Ghana and other low- and middle-income countries. The study provides important information to inform policy on cancer prevention and control in Ghana.

scholarly journals Acute Kidney Injury: Risk Factors and Management Challenges in Low- and Middle-Income Countries

2020 ◽  
pp. 60-67
Author(s):  
Daniela Ponce ◽  
Nilo Kazan ◽  
Adler Pereira ◽  
Andre Babi
Keyword(s):  
Health Care ◽  
Acute Kidney Injury ◽  
Developing Countries ◽  
Global Health ◽  
Injury Risk ◽  
Kidney Injury ◽  
Middle Income ◽  
Middle Income Countries ◽  
Few Data ◽  
Low And Middle Income

Acute kidney injury (AKI) is a major global health problem, occurring in >13 million people and responsible for >2.3 million deaths every year, 85% of which are in developing countries. Although the International Society of Nephrology (ISN) set a goal of eliminating preventable deaths by AKI by 2025, implementation of this program in developing countries presents major challenges for several reasons: there are few data on the epidemiology and causes of AKI in low- and middle-income countries (LMIC); health care resources to diagnose, manage, and treat AKI are often limited; and governments, institutions, and global health initiatives have not focussed sufficiently on the AKI problems. Thus, developing and implementing effective strategies to eliminate preventable deaths from AKI in LMIC have required efforts to better understand how to increase the awareness of AKI by health care workers and institutions.

scholarly journals Gambaran Faktor Risiko Pasien Kanker Serviks di RSUP Dr. M. Djamil Padang Tahun 2019

2021 ◽  
Vol 1 (3) ◽  
pp. 425-430
Author(s):  
Astri Nadia Hidayat ◽  
Novita Ariani ◽  
Ida Rahman Burhan
Keyword(s):  
Cervical Cancer ◽  
Developing Countries ◽  
Medical Records ◽  
Secondary Data ◽  
Age Group ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Middle Income Countries ◽  
Incidence And Mortality ◽  
High Incidence

   Cervical cancer was one of the most common malignancies in women and was the leading cause of death from cancer, especially in low and middle-income countries (developing countries). The high incidence and mortality rate in developing countries was caused by the lack of knowledge about cervical cancer and limited access to early detection, so that patients come late for treatment and were diagnosed when their condition were severe and the disease had progressed to an advanced stage. This study was conducted in the Medical Record Installation section of Dr. M. Djamil Padang Hospital on 11 August - 2 September 2020. The results of the study were obtained from secondary data from medical records, and data collection was taken by total sampling. Samples that have met the inclusion criteria in this study were 84 patients diagnosed with cervical cancer at Dr. M. Djamil Padang Hospital in 2019. The results showed cervical cancer patients at Dr. M. Djamil Padang Hospital in 2019 were mostly in the ≥50 year age group (51.2%), multiparous category (77.4%), and High School/ equivalent category (70.2 %). Keywords : Risk Factor, Cervical Cancer, Age, Parity, Education Level

scholarly journals The global incidence and mortality of contrast-associated acute kidney injury following coronary angiography: a meta-analysis of 1.2 million patients

2021 ◽  
Author(s):  
Zhubin Lun ◽  
Liwei Liu ◽  
Guanzhong Chen ◽  
Ming Ying ◽  
Jin Liu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Rate Change ◽  
Geographic Variations ◽  
Middle Income ◽  
Cochrane Database ◽  
Incidence And Mortality ◽  
Meta Analyses

Abstract Background Contrast-associated acute kidney injury (CA-AKI) is a common complication after coronary angiography (CAG), which brings a poor prognosis. But up to now, there were fewer studies to discuss the incidence of CA-AKI comprehensively. We comprehensively explore the incidence of CA-AKI after coronary angiography. Methods We searched Medline, Embase, and Cochrane Database of Systematic Reviews (to 30th June 2019). We evaluated the world’s incidence of the CA-AKI, and associated mortality, and to described geographic variations according to countries, regions, and economies. CA-AKI was defined as an increase in serum creatinine ≥ 0.5 mg/dl or ≥ 25% within 72 h. Random effects model meta-analyses and meta-regressions was performed to derive the sources of heterogeneity. Results A total of 134 articles (1,211,106 participants) were included in our meta-analysis. Most studies originated from China, Japan, Turkey and United States, from upper middle income and high income countries. The pooled incidence of CA-AKI after coronary angiography was 12.8% (95% CI 11.7–13.9%), and the CA-AKI associated mortality was 20.2% (95% CI 10.7–29.7%). The incidence of CA-AKI and the CA-AKI associated mortality were not declined over time (Incidence rate change: 0.23% 95% CI − 0.050 to 0.510 p = 0.617; Mortality rate change: − 1.05% 95% CI − 3.070 to 0.970 p = 0.308, respectively). Conclusion CA-AKI was a universal complication in many regions, and the burden of CA-AKI remains severe. In clinical practice, physicians should pay more attention to the occurrence and active prevention and treatment of CA-AKI. Graphic abstract

scholarly journals Acute Kidney Injury Recognition in Low- and Middle-Income Countries

2017 ◽  
Vol 2 (4) ◽  
pp. 530-543 ◽  
Author(s):  
Jorge Cerdá ◽  
Sumit Mohan ◽  
Guillermo Garcia-Garcia ◽  
Vivekanand Jha ◽  
Srinivas Samavedam ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income
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