Incidence and Risk Factors of Postoperative Acute Kidney Injury in Non- Cardiac Major Surgery.

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

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Common Risk Factors Responsible for Acute Kidney Injury among Children: Experience at Medical University in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v7i1.54751 ◽

2021 ◽

Vol 7 (1) ◽

pp. 42-46

Author(s):

Sharmin Akter Luna ◽

Jakia Sultana ◽

Abdullah Al Mamun ◽

Afroza Begum ◽

Md Habibur Rahman ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Injury ◽

Cross Sectional Study ◽

Cross Sectional ◽

Radiocontrast Agent ◽

Nephrotoxic Drugs ◽

Common Risk Factors ◽

One Year ◽

Medical University

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

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

International Journal of Advanced Nursing Studies ◽

10.14419/ijans.v6i1.7170 ◽

2017 ◽

Vol 6 (1) ◽

pp. 11

Author(s):

Amal Abd El-Hafez1 ◽

Asmaa Mahjoub ◽

Eman Ahmad

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Critical Care ◽

Sofa Score ◽

Postpartum Hemorrhage ◽

Kidney Injury ◽

Total Sample ◽

Critical Care Nurses ◽

Cross Sectional ◽

Pregnancy And Postpartum

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.

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ICU treatment of acute kidney injury

10.1093/med/9780199568741.003.0151 ◽

2018 ◽

Author(s):

Matt Wise ◽

Paul Frost

Keyword(s):

Risk Factors ◽

Septic Shock ◽

Acute Kidney Injury ◽

Haematological Malignancy ◽

Previous History ◽

Kidney Injury ◽

History Of ◽

Nephrotoxic Drugs ◽

Abdominal Compartment ◽

Icu Treatment

Traditionally, the etiology of acute kidney injury (AKI) is considered in terms of prerenal, renal, and obstructive causes. However, this categorization is less useful in the ICU, where the etiology of AKI is usually multifactorial and often occurs in the context of multi-organ failure. Hypotension, nephrotoxic drugs, and severe sepsis or septic shock are the most important identifiable factors. Less frequently encountered causes include pancreatitis, abdominal compartment syndrome, and rhabdomyolysis. Primary intrinsic renal disease such as glomerulonephritis is extremely uncommon. A previous history of cirrhosis, cardiac failure, or haematological malignancy, and age >65 years, are important risk factors. This chapter covers symptoms, complications, diagnosis, investigations, prognosis, and treatment of renal failure in the ITU.

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PREOPERATIVE RISK FACTORS FOR ACUTE KIDNEY INJURY AFTER LIVER TRANSPLANTATION: RESULTS FROM A CROSS-SECTIONAL STUDY IN NORTHEAST OF BRAZIL

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-03 ◽

2018 ◽

Vol 55 (1) ◽

pp. 18-22 ◽

Cited By ~ 3

Author(s):

Raimundo Martins GOMES JUNIOR ◽

Lia Cavalcante CEZAR ◽

Gdayllon Cavalcante MENESES ◽

Geraldo Bezerra da SILVA JUNIOR ◽

José Huygenes Parente GARCIA ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Serum Albumin ◽

Kidney Injury ◽

Cross Sectional Study ◽

Sectional Study ◽

Preoperative Risk ◽

Cross Sectional ◽

Preoperative Risk Factors

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.

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Acute Kidney Injury in Critically Ill Children: A Retrospective Analysis of Risk Factors

Blood Purification ◽

10.1159/000502081 ◽

2019 ◽

Vol 49 (1-2) ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Francesca De Zan ◽

Angela Amigoni ◽

Roberta Pozzato ◽

Andrea Pettenazzo ◽

Luisa Murer ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Critically Ill ◽

Significant Risk ◽

Kidney Injury ◽

Multiple Organ ◽

Critically Ill Children ◽

Multiple Organ Dysfunction ◽

Risk Of Mortality ◽

Nephrotoxic Drugs

Introduction: Children admitted to paediatric intensive care unit (PICU) are at risk of acute kidney injury (AKI). However, few paediatric studies have focused on the identification of factors potentially associated with the development of this condition. The aim of our study was to assess the incidence rate of AKI, identify risk factors, and evaluate clinical outcome in a large sample of critically ill children. Methods: This retrospective observational study was conducted including patients admitted to our PICU from January 2014 to December 2016. AKI was defined according to Kidney Disease: Improving Global Outcome criteria. Results: A total of 222 PICU patients out of 811 (27%) had AKI (stage I 39%, stage II 24%, stage III 37%). The most common PICU admission diagnoses in AKI cases were heart disease (38.6%), respiratory failure (16.8%) and postsurgical non-cardiac patients (11%). Hypoxic-ischaemic was the most frequent cause of AKI. Significant risk factors for AKI following multivariate analysis were age >2 months (OR 2.43; 95% CI 1.03–7.87; p = 0.05), serum creatinine at admission >44 µmol/L (OR 2.23; 95% CI 1.26–3.94; p = 0.006), presence of comorbidities (OR 1.84; 95% CI 1.03–3.30; p = 0.04), use of inotropes (OR 2.56; 95% CI 1.23–5.35; p= 0.012) and diuretics (OR 2.78; 95% CI 1.49–5.19; p = 0.001), exposure to nephrotoxic drugs (OR 1.66; 95% CI 1.01–2.91; p= 0.04), multiple organ dysfunction syndrome (OR 2.68; 95% CI 1.43–5.01; p = 0.002), and coagulopathy (OR 1.89; 95% CI 1.05–3.38, p = 0.03). AKI was associated with a significant longer PICU stay (median LOS of 8 days, interquartile range [IQR] 3–16, versus 4 days, IQR 2–8, in non-AKI patients; p < 0.001). The mortality rate resulted tenfold higher in AKI than non-AKI patients (12.6 vs. 1.2%; p < 0.001). Conclusions: The incidence of AKI in critically ill children is high, with an associated increased length of stay and risk of mortality. In the PICU setting, risk factors of AKI are multiple and mainly associated with illness severity.

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Predictive Capacity of ACEF Score to Detect All-Cause Mortality and Post Contrast Acute Kidney Injury Among PCI Patients

Nepalese Heart Journal ◽

10.3126/njh.v17i2.32674 ◽

2020 ◽

Vol 17 (2) ◽

pp. 21-27

Author(s):

Parag Karki ◽

Arun Maskey ◽

Birat Krishna Timalsena ◽

Samir Kumar Poudel ◽

Binayak Gautam ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Goodness Of Fit ◽

Total Mortality ◽

Kidney Injury ◽

Cross Sectional ◽

Post Contrast ◽

Killip Class ◽

Reduced Ejection Fraction ◽

Discriminatory Capacity

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.

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Incidence and Risk Factors for Early Acute Kidney Injury in Nonsurgical Patients: A Cohort Study

International Journal of Nephrology ◽

10.1155/2017/5241482 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Javier Enrique Cely ◽

Elkin José Mendoza ◽

Carlos Roberto Olivares ◽

Oscar Julián Sepúlveda ◽

Juan Sebastián Acosta ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Hospital Stay ◽

Kidney Injury ◽

Length Of Hospital Stay ◽

Epidemiological Data ◽

Hospital Death ◽

Prehospital Treatment ◽

Nephrotoxic Drugs ◽

Nonsurgical Patients

Introduction. Detecting acute kidney injury (AKI) in the first days of hospitalization could prevent potentially fatal complications. However, epidemiological data are scarce, especially on nonsurgical patients.Objectives. To determine the incidence and risk factors associated with AKI within five days of hospitalization (EAKI).Methods. Prospective cohort of patients hospitalized in the Internal Medicine Department.Results. A total of 16% of 400 patients developed EAKI. The associated risk factors were prehospital treatment with nephrotoxic drugs (2.21 OR; 95% CI 1.12–4.36,p=0.022), chronic kidney disease (CKD) in stages 3 to 5 (3.56 OR; 95% CI 1.55–8.18,p<0.003), and venous thromboembolism (VTE) at admission (5.05 OR; 95% CI 1.59–16.0,p<0.006). The median length of hospital stay was higher among patients who developed EAKI (8 [IQR 5–14] versus 6 [IQR 4–10],p=0.008) and was associated with an increased requirement for dialysis (4.87 OR 95% CI 2.54 to 8.97,p<0.001) and in-hospital death (3.45 OR; 95% CI 2.18 to 5.48,p<0.001).Conclusions. The incidence of EAKI in nonsurgical patients is similar to the worldwide incidence of AKI. The risk factors included CKD from stage 3 onwards, prehospital treatment with nephrotoxic drugs, and VTE at admission. EAKI is associated with prolonged hospital stay, increased mortality rate, and dialysis requirement.

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The characteristics and mortality risk factors for acute kidney injury in different age groups in China—a cross sectional study

Renal Failure ◽

10.1080/0886022x.2016.1227618 ◽

2016 ◽

Vol 38 (9) ◽

pp. 1413-1417 ◽

Cited By ~ 5

Author(s):

Qing Wei ◽

Hong Liu ◽

Yan- Tu ◽

Ri-Ning Tang ◽

Yan-Li Wang ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Mortality Risk ◽

Age Groups ◽

Kidney Injury ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Incidence and Risk Factors of Acute Kidney Injury in Acute Stroke - in a Tertiary Care Hospital

Community Based Medical Journal ◽

10.3329/cbmj.v8i1.55664 ◽

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 ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Acute Stroke ◽

Tertiary Care ◽

Kidney Injury ◽

Care Hospital ◽

Stroke Patients ◽

College Hospital ◽

Cross Sectional

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

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Risk Factors for Acute Kidney Injury and Chronic Kidney Disease following Allogeneic Hematopoietic Stem Cell Transplantation for Hematopoietic Malignancies

Acta Haematologica ◽

10.1159/000504354 ◽

2019 ◽

Vol 143 (5) ◽

pp. 452-464 ◽

Cited By ~ 1

Author(s):

Masahiro Sakaguchi ◽

Kazutaka Nakayama ◽

Hiroki Yamaguchi ◽

Akiko Mii ◽

Akira Shimizu ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Stem Cell ◽

Kidney Disease ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Kidney Injury ◽

Hematopoietic Stem ◽

Nephrotoxic Drugs

Background: Acute kidney injury (AKI) and chronic kidney disease (CKD) are considered common complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Objectives and Method: In this study, 114 patients who had undergone allo-HSCT were retrospectively analyzed to investigate the risk factors for onset of posttransplant AKI and CKD as defined by the new Kidney Disease Improving Global Outcomes criteria. Results: Seventy-four patients (64.9%) developed AKI and 25 (21.9%) developed CKD. The multivariate analysis showed that the risk factors for developing stage 1 or higher AKI were age ≥46 years at the time of transplant (p = 0.001) and use of ≥3 nephrotoxic drugs (p = 0.036). For CKD, the associated risk factors were disease status other than complete remission at the time of transplantation (p = 0.018) and onset of AKI after transplant (p = 0.035). The 5-year overall survival (OS) was significantly reduced by development of AKI (p < 0.001), but not CKD. Posttransplant AKI significantly increased the 5-year nonrelapse mortality (p < 0.001), whereas posttransplant CKD showed an increasing tendency, but the difference was not significant. Conclusions: Posttransplant AKI impacts OS, significantly increases the risk of CKD, and is significantly associated with disseminated intravascular coagulation and use of ˃3 nephrotoxic drugs.

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