scholarly journals Clinical profile of acute kidney injury in neonates with perinatal asphyxia

2021 ◽  
Author(s):  
Revanasiddappa Bhosgi ◽  
Kirankumar Harwalkar
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Serum Creatinine ◽  
Early Recognition ◽  
Perinatal Asphyxia ◽  
Kidney Injury ◽  
Term Neonates ◽  
Renal Functions ◽  
Appropriate Treatment ◽  
Stage 1

Background: Acute kidney injury (AKI) is one of the most common complication observed in perinatal asphyxia. Early recognition is required for appropriate treatment and improve the outcome.Methods: It is a hospital based retrospective study conducted from august 2019 to December 2019. Total 85 full term neonates with perinatal asphyxia were included in the study. Renal functions were assessed by monitoring urine output, serum creatinine and ultrasonography. Acute kidney injury assessed by pRIFLE criteria and HIE staging is done by modified Sarnat and Sarnat staging. Severity of AKI is correlated with stages of HIE. AKI is managed as per unit protocol.Results: Total 85 perinatal asphyxia neonates were included in the study. Out of total 85 neonates, 25 (29.4%) neonates had evidence of acute kidney injury. Among 25 neonates with acute kidney injury, higher percentage was observed in male neonates which was 14 (56%) against 11 (44%) among female neonates. Predominantly, non oligouric acute kidney injury was observed among acute kidney injury neonates which accounted to 20 neonates (80%) (p-0.258). Serum creatinine between 1.5-2 mg/dl was observed in 18 (21.1%) neonates and 7 (8.2%) neonates had creatinine between 2-3 mg/dl. Sonological abnormality was noted in 2 (2.3%) neonates. Among neonates with non oligouric AKI, 3 (12%) neonates had HIE stage 1, 15 (60%) had HIE-2 and 7 (28%) had HIE-3. However, neonates with non oligouric AKI were higher among HIE 2 when compared to neonates with oligouric renal failure who were higher in HIE 3. No mortality occurred among these neonates.Conclusions: Majority of the neonates with perinatal asphyxia had non oliguric AKI which responded well to conservative treatment. AKI is most commonly seen in HIE stage 2 babies. Since non oligouric renal failure was a predominant finding among asphyxiated neonates, Serum creatinine monitoring remains main stay of diagnosis. 

Abstract 203: Acute Kidney Injury in Acute Ischemic Stroke Patients Receiving Endovascular Treatment: Analysis of the Interventional Management of Stroke (IMS) - III

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Nabeel A Herial ◽  
Muhammad A Saleem ◽  
Muhammad Shah Miran ◽  
Adnan I Qureshi
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Ischemic Stroke ◽  
Serum Creatinine ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Kidney Injury ◽  
Stroke Patients ◽  
Intravenous Treatment ◽  
Stage 1

Background: Endovascular treatment involves cerebral angiography with injection of contrast agents that are nephrotoxic and carry risk of renal failure. Our objective was to determine the incidence and identify predictors associated with acute kidney injury in ischemic stroke patients undergoing endovascular treatment. Materials and methods: Data from the Interventional Management of Stroke (IMS) - III clinical trial was utilized in which acute ischemic stroke patients were randomized into endovascular or intravenous treatment groups. Baseline and day 5 or discharge serum creatinine levels along with the demographic and comorbidity information was collected. Acute Kidney Injury classification was used to ascertain severity of renal dysfunction and based on increase in Day 5 creatinine levels from baseline, stage 1 (1.5 to 2 fold), stage 2 (>2 to 3 fold), and stage 3 renal failure (>3 fold increase from baseline) were identified. Results: Total of 434 patients received ET and 222 patients received intravenous treatment (IVT) with tissue plasminogen activator (tPA). Increase in serum creatinine levels was observed in 52 patients (12%) receiving ET and 24 patients (11%) in the IVT group. Renal failure (stage 1 or higher) was observed in 5 patients (1.2%) in the ET group and 3 patients (1.4%) in the IVT group. In univariate analysis, only age was associated with higher incidence of renal failure in the ET group. No significant association was observed with comorbid diagnoses, particularly pre-existing hypertension or diabetes mellitus. Baseline creatinine level was associated with renal failure (p=0.029) in patients receiving ET and pre-existing diagnosis of renal disorders was associated with renal failure in patients receiving IVT. Conclusions: In the IMS III data, incidence of acute kidney injury in acute ischemic stroke was low and was not different from patients receiving IVT.

Predicting Severity of Acute Kidney Injury in Term Neonates with Perinatal Asphyxia Using Urinary Neutrophil Gelatinase Associated Lipocalin

2016 ◽  
Vol 83 (12-13) ◽  
pp. 1374-1378 ◽  
Author(s):  
Vasanthan Tanigasalam ◽  
Ballambattu Vishnu Bhat ◽  
Bethou Adhisivam ◽  
Magadi Gopalakrishna Sridhar ◽  
Kottyen Thazath Harichandrakumar
Keyword(s):  
Acute Kidney Injury ◽  
Perinatal Asphyxia ◽  
Kidney Injury ◽  
Term Neonates ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

scholarly journals Comparative study of clinico-biochemical profile and outcome of acute kidney injury in outborn and inborn neonates

2018 ◽  
Vol 5 (4) ◽  
pp. 1490
Author(s):  
Nayan Kumar ◽  
B. S. Karnawat ◽  
Navneet Badaya
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Poor Prognosis ◽  
Perinatal Asphyxia ◽  
Kidney Injury ◽  
Clinical Problem ◽  
Biochemical Profile ◽  
Associated Risk Factors ◽  
Major Clinical Problem

Background: Acute Kidney Injury (AKI) is one of the major clinical problem in hospitalised neonates having variable outcomes. Prognosis depends on early diagnosis, associated risk factors and type of renal failure. The present study was undertaken to evaluate and compare risk factors, biochemical derangements and outcome of AKI in outborn and inborn neonates.Methods: For this hospital based prospective study 100 neonates were enrolled who were admitted in the NICU, diagnosed as AKI who had serum creatinine >1.5mg/dl. Study was done for 1 year from June 2016 onwards.Results: A large majority (72.3%) cases were outborn neonates (extramural) whereas (27.7%) cases were inborn neonates (intramural). Most of (79.8%) cases were term and were admitted during summer months. In outborn, type of AKI in descending order was prerenal (64.7%), renal (33.8%) and postrenal (1.5%) while in inborn neonates, cases were equally (50%) divided in between renal and prerenal. Among outborn neonates risk factors for AKI was dehydration (44%), sepsis (28%) and shock (16%) whereas in inborn, perinatal asphyxia (31%), dehydration (27%), shock (23%) and sepsis (11.5%) were risk factors. In outborn 36.8% cases were oliguric whereas in inborn 53.9% cases were oliguric.Conclusions: The maximum cases of AKI were outborn neonates in which outborn dehydration was the commonest cause while in inborn neonates perinatal asphyxia was the commonest cause. Sepsis and shock were other causes in both groups. Presence of oliguria, intrinsic AKI and shock carried poor prognosis.

Chronic Kidney Disease

2016 ◽  
pp. 565-570
Author(s):  
Carrie A. Schinstock
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Relative Increase ◽  
Absolute Increase ◽  
Definition Of ◽  
Stage 1

The term acute kidney injury (AKI) has replaced acute renal failure in contemporary medical literature. AKI denotes a rapid deterioration of kidney function within hours to weeks, resulting in the accumulation of nitrogenous metabolites in addition to fluid, electrolyte, and acid-base imbalances. The definition of AKI was refined to a 3-stage definition, with criteria for stage 1 as follows: 1) an absolute increase in serum creatinine (SCr) by at least 0.3 mg/dL from baseline within 48 hours; or 2) a relative increase in SCr to at least 1.5 times baseline within the past 7 days; or 3) urine output decreased to less than 0.5 mL/kg/h for 6 hours.

scholarly journals Maternal-Perinatal Variables in Patients with Severe Preeclampsia Who Develop Acute Kidney Injury

2021 ◽  
Vol 10 (23) ◽  
pp. 5629
Author(s):  
Patrocinio Rodríguez-Benitez ◽  
Irene Aracil Moreno ◽  
Cristina Oliver Barrecheguren ◽  
Yolanda Cuñarro López ◽  
Fátima Yllana ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Uric Acid ◽  
Caesarean Section ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Severe Preeclampsia ◽  
History Of ◽  
Nicu Admission

Introduction: At present, we are witnessing an increase in preeclampsia, especially the most severe forms, which are associated with an increased risk of maternal-perinatal morbidity and mortality. As a severity criterion, acute kidney injury (AKI) has been associated with a worse prognosis, and for this reason, the maternal and perinatal variables associated with AKI in patients with severe preeclampsia (SP) were analysed in this study. Methods: An observational, retrospective, single-centre study of patients with SP treated at a tertiary hospital between January 2007 and December 2018 was conducted. The case criteria based on the criteria established by the ACOG Practice Guidelines for Gestational Hypertension and Preeclampsia. AKI is considered when serum creatinine exceeds 1.1 mg/dL in a pregnant woman with previously normal renal function. In patients with existing chronic kidney disease (CKD), it is referred to as AKI if the baseline serum creatinine increases by 1.5 fold. Pregestational, gestational and postpartum variables were analysed up to 12 weeks postpartum using univariate and multivariate logistic regression analysis. Results: During the study period, 76,828 births were attended, and 303 pregnant women were diagnosed with SP. The annual incidence of SP increased gradually throughout the study period, reaching 1.79/100 births/year in 2018. Acute kidney injury (AKI) occurred in 24.8% of the patients. The multivariate analysis revealed an increased association with a history of previous CKD, the use of assisted reproductive techniques and caesarean section. Uric acid and thrombotic microangiopathy (TMA) had a high correlation with AKI. Indications for caesarean section are associated with AKI in SP. Regarding perinatal outcomes in cases of AKI, there was a higher percentage of neonates who required foetal lung maturation with steroids and an increased need for NICU admission. No case of maternal death was recorded; however, an increase in neonatal mortality was found among patients who did not develop AKI. After 12 weeks postpartum, 72 patients were referred to the nephrology consultation for persistent hypertension, proteinuria or renal failure. Conclusions: In preeclampsia, AKI is a common complication, especially among patients with a history of CKD, those who became pregnant using assisted reproduction techniques and those who delivered via caesarean section. The perinatal impact of AKI is mainly centred on a higher rate of NICU admission and a lower mortality rate. Among biochemical and haematological markers, the uric acid level prior to renal failure has a direct and significant correlation with the risk of AKI, as does the development of TMA in patients with preeclampsia. Therefore, the monitoring of renal function in cases of preeclampsia should be strict, and referral for a nephrology consultation may be necessary in some cases.

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 Acute Kidney Injury (AKI) in perinatal asphyxia

2014 ◽  
Vol 2 (02) ◽  
pp. 60-65 ◽  
Author(s):  
Girish Gopal
Keyword(s):  
Acute Kidney Injury ◽  
Creatinine Clearance ◽  
Biochemical Parameters ◽  
Perinatal Asphyxia ◽  
Fluid Challenge ◽  
Kidney Injury ◽  
Renal Functions ◽  
Significant Difference ◽  
Urine Microscopy ◽  
Ischemic Encephalopathy

Background: Acute kidney injury (AKI) is a common consequence of perinatal asphyxia, occurring in upto 56% of these neonates. It is important to recognize AKI in asphyxiated neonates to facilitate administration of appropriate fluids and electrolytes in order to improve their outcome. Objectives: To determine the incidence of AKI in asphyxiated neonates and to correlate the severity and type of AKI with Apgar score and severity of hypoxic ischemic encephalopathy (HIE). Methods: 75 neonates were enrolled – 50 asphyxiated and 25 healthy neonates. Renal functions were assessed using urine output, urine microscopy, biochemical parameters and sonography. The values obtained were correlated with the severity of HIE. Neonates with AKI were managed as per unit protocol. Results: Of the 50 asphyxiated neonates, 32 (64%) had AKI: 25 (78.12 %) neonates with pre-renal AKI and the remaining 7 (21.88 %) with intrinsic AKI. Out of the 32 asphyxiated neonates with AKI, 12 (37.5%) had oliguric AKI, while the remaining 20 (62.5%) had non-oliguric AKI. Levels of blood urea and serum creatinine were significantly higher in asphyxiated neonates as compared to healthy controls (p 0.001). Biochemical derangements correlated well with the severity of HIE and Apgar scores. Serum sodium and creatinine clearance showed significantly different values in asphyxiated babies compared to controls. There was no significant difference in the urine ouput in the control and study group. Sonographic abnormalities were seen most often in oliguric babies, and indicated bad prognosis. Mortality was higher in babies with oliguric AKI. Conclusions: Perinatal asphyxia is an important cause of neonatal AKI. Majority of the babies had non-oliguric AKI and responded well to fluid challenge. Abnormalities in the renal function correlates well with the severity of HIE. Intrinsic AKI, oliguria, hyponatremia, reduced creatinine clearance and abnormal sonographic scan suggest bad prognosis in neonatal AKI secondary to perinatal asphyxia.

scholarly journals The risk of development of acute kidney injury in full-term infants with administration of methylxanthines

Pathologia ◽  
2021 ◽  
Vol 18 (2) ◽  
pp. 152-158
Author(s):  
L. S. Stryzhak ◽  
I. O. Anikin ◽  
O. V. Spakhi
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Comparison Group ◽  
Perinatal Asphyxia ◽  
Statistical Significance ◽  
Kidney Injury ◽  
Main Group ◽  
Full Term ◽  
Term Infants ◽  
Caffeine Citrate

Exploring new possibilities for the use of methylxanthines to prevent the development of acute kidney injury (AKI) in full-term infants with perinatal asphyxia. Aim: to evaluate the efficacy and safety of methylxanthines in full-term infants for the prevention and conservative treatment of acute kidney injury. Materials and methods. To test the effectiveness of the proposed method of AKI treatment, 38 infants were chosen and divided into 2 groups by random selection. Nursing and intensive care were according to current legislation (Order of the Ministry of Health of Ukraine No. 225 of March 28, 2014). The main group (n = 20) received therapy with caffeine citrate, the comparison group (n = 18) – theophylline. Both of these drugs were used to prevent the development of acute kidney injury – stage II and III according to KDIGO. Results. A significant difference in serum creatinine was found in the main group - the level of serum creatinine was higher than in the comparison group, but did not exceed the physiological norm. GFR on the 3rd day of life was higher with administration of theophylline, but in the group of caffeine did not exceed the reference values of the norm. No differences between urea levels and diuresis rates were found in the groups. The initial results indicate the lack of statistical significance when using various drugs of the methylxanthine group, namely theophylline and caffeine citrate. This is explained by the fact that in the main group 65.00 % (n = 13) of patients had AKI stage 0 according to KDIGO, and 35.00 % (n = 7) had stage I. In the comparison group, 55.56 % (n = 10) and 44.44 % (n = 8), respectively. Stages II and III in both groups of the study did not develop, the obtained data are equivalent – U = 163,00; P = 0,6296. However, the use of caffeine citrate may become a priority due to a better safety profile compared to theophylline. Caffeine is less likely to cause adverse effects in the form of non-pathological bile vomiting and has significantly lower relative risk of non-pathological bile vomiting in infants (RR 0.26 (95 % CI 0.10; 0.66)). Conclusions. Conservative methylxanthine therapy in full-term infants with perinatal asphyxia prevents the development of stages II and III of AKI according to KDIGO. However, it is necessary to continue the collection of material to increase the statistical significance, as well as to study the early and long-term consequences of this therapy.

scholarly journals MO380INCREASED PREVALENCE OF ACUTE KIDNEY INJURY AND MORTALITY IN COVID-19 HOSPITALIZED PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Umberto Maria Morosini ◽  
Greta Rosso ◽  
Guido Merlotti ◽  
Andrea Colombatto ◽  
Angelo Nappo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Hospital Stay ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Strong Impact ◽  
Icu Admission ◽  
Increased Risk ◽  
Stage 1

Abstract Background and Aims In 2020, SARS-CoV-2 pandemic had a devastating impact on individuals and on national health systems worldwide. Although being primarily a lung disease, COVID-19-associated systemic inflammation and activation of coagulation/complement cascades lead to multiple organ dysfunction including Acute Kidney Injury (AKI). Our aim is to evaluate AKI prevalence and mortality in hospitalized patients during COVID-19 pandemic in a 500-bed University Hospital. Method Observational study on 945 COVID-19 patients (March-May 2020). Data collection from Board Hospital Discharge and serum creatinine (Lab database). AKI stratification in accordance to KDIGO criteria and evaluation of outcome in the different subgroups. The same methodology was adopted to assess AKI prevalence and outcome in 2018-2019. Results 351/945 (37.14%) of all hospital admissions for COVID-19 showed AKI further sub-classified as follows: 173 (18.3%) stage 1, 112 (11.9%) stage 2 and 66 (6.9%) stage 3: the control NO AKI group was 594/945 (62.86%). COVID-associated AKI prevalence was higher than that observed in 2018 (total AKI 17.9%, stage 1 10.7%, stage 2 4.5%, stage 3 2.7%) and 2019 (total AKI 17.2%, stage 1 10.1%, stage 2 4.5%, stage 3 2.6%). During COVID-19 pandemic, in-hospital mortality was 27% for NO AKI group, 28% for total AKI group, further subdivided 24% for stage 1, 45% for stage 2 and 42% for stage 3 group, respectively. Mortality was different from that observed during 2018 (NO AKI 3.77%, total AKI 15.2%, stage 1 9.69%, stage 2 17.24%, stage 3 18.9%) and 2019 (NO AKI 3.56%, total AKI 18.35%, stage 1 10.6%, stage 2 20.1%, stage 3 24.3%). In COVID-19 patients, mean age of NO AKI group was 64.6 ys vs. 71.7 ys of total AKI group divided in 71.6 ys for stage 1, 74.3 ys for stage 2 and 67.9 ys for stage 3, respectively. Mean eGFR at admission was 74.2 ml/min for NO AKI group, 61.3 ml/min for total AKI group divided in 64.3 ml/min for stage 1, 57.8 ml/min for stage 2 and 52.5 ml/min for stage 3. Mean serum creatinine at admission was 1.17 mg/dl in NO AKI group, 1.43 mg/dl for total AKI group divided in1.22 mg/dl for stage 1, 1.4 mg/dl for stage 2 and 2.25 mg/dl for stage 3. Among evaluated comorbidities, only diabetes (p=0,048) and cognitive impairment (p=0,001) were associated with a significant increased risk for AKI development. ICU admission rate was 5% for NO AKI group and 18% for total AKI group divided in 14% for stage 1, 22% for stage 2 and 44% for stage 3. Mean length of hospital stay for NO AKI group was 7.22 days vs 15.08 days for total AKI group divided in 13.67 for stage 1, 15.83 for stage 2 and 21.82 for stage 3. Of note, all different therapies administered to COVID-19 patients did not correlate with AKI incidence. Mean eGFR at discharge was 76 ml/min for NO AKI group vs 66 ml/min for total AKI group divided in 68.7 ml/min for stage 1, 59.3 ml/min for stage 2 and 59.3 ml/min for stage 3. Mean serum creatinine at discharge was 1.14 mg/dl for NO AKI group vs 1.45 mg/dl for total AKI group divided in 1.28 mg/dl for stage 1, 1.58 mg/dl for stage 2 and 2.05 mg/dl for stage 3. Conclusion COVID-19 pandemic is associated with an increased AKI prevalence in hospitalized patients (2-fold increase in all KDIGO stages). AKI associated with an increased risk of mortality: of note, AKI stage2-3 had a strong impact on mortality in comparison to NO AKI group (OR 2.59 and 2.11, respectively). The presence of eGFR >60 ml/min and serum creatinine < 1.2 mg/dl at admission were associated with a lower risk of AKI development: reduced eGFR levels were observed at discharge particularly in AKI stage 2-3. The length of hospital stay and risk of ICU admission depended on AKI incidence and severity. COVID-19 lead to an increased burden for Nephrologists due to increased AKI prevalence: a nephrological follow-up is needed to avoid progression from AKI to chronic kidney disease (CKD).

scholarly journals Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bertha M. Córdova-Sánchez ◽  
Ángel Herrera-Gómez ◽  
Silvio A. Ñamendys-Silva
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Cancer Patients ◽  
Critically Ill ◽  
Urine Output ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Risk Of Death ◽  
Increased Risk ◽  
Stage 1

Acute kidney injury (AKI) is common in critically ill patients and is associated with higher mortality. Cancer patients are at an increased risk of AKI. Our objective was to determine the incidence of AKI in our critically ill cancer patients, using the criteria of serum creatinine (SCr) and urine output (UO) proposed by the Kidney Disease: Improving Global Outcomes (KDIGO).Methods.We performed a retrospective cohort analysis of a prospectively collected database at the intensive care unit (ICU) of the Instituto Nacional de Cancerología from January 2013 to March 2015.Results.We classified AKI according to the KDIGO definition. We included 389 patients; using the SCr criterion, 192 (49.4%) had AKI; using the UO criterion, 219 (56.3%) had AKI. Using both criteria, we diagnosed AKI in 69.4% of patients. All stages were independently associated with six-month mortality; stage 1 HR was 2.04 (95% CI 1.14–3.68,p=0.017), stage 2 HR was 2.73 (95% CI 1.53–4.88,p=0.001), and stage 3 HR was 4.5 (95% CI 2.25–8.02,p<0.001). Patients who fulfilled both criteria had a higher mortality compared with patients who fulfilled just one criterion (HR 3.56, 95% CI 2.03–6.24,p<0.001).Conclusion.We diagnosed AKI in 69.4% of patients. All AKI stages were associated with higher risk of death at six months, even for patients who fulfilled just one AKI criterion.

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