Incidence and Risk Factors of Acute Kidney Injury in ICU Patients of Omdurman Teaching Hospital

Abstract Background: acute kidney injury is a common complication in critically ill patients and it is commonly associated with high mortality and morbidity with adverse short and long term outcome. bjectives: The main objective of this study was to determine the frequency of acute kidney injury in ICU patients in Omdurman teaching hospital. And to assess the risk factors associated with the development of acute kidney injury (AKI) in a critically ill patient. We also intended to correlate acute kidney injury with the primary disease required admitting to ICU and find out the impact of acute kidney injury in ICU outcomes. Methods: In this descriptive prospective, cohort hospital-based study, 211 patients were studied and followed up during admission in ICU using standardized questionnaire to collect clinical data and investigation Results: a total of 61 patients has been included in the study developed renal impairment during their stay in ICU 39 (64%) patients were males and 22 ( 36%) were female mean age was 41 ± 5 renal impairment developed after mean of 5 days of admission and the most common cause was decreased level of consciousness and severe hypotension. sepsis accounting for 40% of the admission. The outcome in ICU showed that the mortality rate was high up to 41% in kidney injury patients Sepsis account for over 96 % (24 patients) who have passed away. Conclusions: development of AKI in ICU is an important risk factor for poor outcomes in critically setting. Prevention is the best method for avoiding AKI, with the early identification and recognition of high-risk patients.

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Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2018-0240 ◽

2019 ◽

Vol 41 (4) ◽

pp. 462-471 ◽

Cited By ~ 4

Author(s):

Kellen Hyde Elias Pinheiro ◽

Franciana Aguiar Azêdo ◽

Kelsy Catherina Nema Areco ◽

Sandra Maria Rodrigues Laranja

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Kidney Injury ◽

Mortality Rates ◽

Icu Patients ◽

Septic Acute Kidney Injury ◽

Observational Cohort ◽

Worse Prognosis

Abstract Acute kidney injury (AKI) has an incidence rate of 5-6% among intensive care unit (ICU) patients and sepsis is the most frequent etiology. Aims: To assess patients in the ICU that developed AKI, AKI on chronic kidney disease (CKD), and/or sepsis, and identify the risk factors and outcomes of these diseases. Methods: A prospective observational cohort quantitative study that included patients who stayed in the ICU > 48 hours and had not been on dialysis previously was carried out. Results: 302 patients were included and divided into: no sepsis and no AKI (nsnAKI), sepsis alone (S), septic AKI (sAKI), non-septic AKI (nsAKI), septic AKI on CKD (sAKI/CKD), and non-septic AKI on CKD (nsAKI/CKD). It was observed that 94% of the patients developed some degree of AKI. Kidney Disease Improving Global Outcomes (KDIGO) stage 3 was predominant in the septic groups (p = 0.018). Nephrologist follow-up in the non-septic patients was only 23% vs. 54% in the septic groups (p < 0.001). Dialysis was performed in 8% of the non-septic and 37% of the septic groups (p < 0.001). Mechanical ventilation (MV) requirement was higher in the septic groups (p < 0.001). Mortality was 38 and 39% in the sAKI and sAKI/CKD groups vs 16% and 0% in the nsAKI and nsAKI/CKD groups, respectively (p < 0.001). Conclusions: Patients with sAKI and sAKI/CKD had worse prognosis than those with nsAKI and nsAKI/CKD. The nephrologist was not contacted in a large number of AKI cases, except for KDIGO stage 3, which directly influenced mortality rates. The urine output was considerably impaired, ICU stay was longer, use of MV and mortality were higher when kidney injury was combined with sepsis.

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Characteristics and risk factors of postoperative acute kidney injury in ICU patients

International Urology and Nephrology ◽

10.1007/s11255-018-1981-z ◽

2018 ◽

Vol 50 (11) ◽

pp. 2111-2112

Author(s):

Liu-Jia-Zi Shao ◽

Fu-Shan Xue ◽

Rui-Juan Guo ◽

Li Zheng

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Kidney Injury ◽

Icu Patients

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Acute Kidney Injury Risk Factors For ICU Patients Following Cardiac Surgery: The Application of Joint Modeling

Trauma Monthly ◽

10.5812/traumamon.23749 ◽

2016 ◽

Vol 21 (4) ◽

Cited By ~ 4

Author(s):

Batoul Khoundabi ◽

Anoshirvan Kazemnejad ◽

Marjan Mansourian ◽

Seyed Mohammadreza Hashemian ◽

Mehdi Kazempoor Dizaji

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

Injury Risk ◽

Kidney Injury ◽

Joint Modeling ◽

Icu Patients ◽

Injury Risk Factors

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Survival in Critically Ill Patients with Acute Kidney Injury Treated with Early Hemodiafiltration

The International Journal of Artificial Organs ◽

10.1177/039139881203501202 ◽

2012 ◽

Vol 35 (12) ◽

pp. 1039-1046 ◽

Cited By ~ 3

Author(s):

Nicolas Boussekey ◽

Benoit Capron ◽

Pierre-Yves Delannoy ◽

Patrick Devos ◽

Serge Alfandari ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Critically Ill ◽

Mortality Risk ◽

Critically Ill Patients ◽

Kidney Injury ◽

Icu Patients ◽

Impact On Survival ◽

Baseline Characteristics ◽

The Moment

Purpose Early renal replacement therapy (RRT) initiation should theoretically influence many physiological disorders related to acute kidney injury (AKI). Currently, there is no consensus about RRT timing in intensive care unit (ICU) patients. Methods We performed a retrospective analysis of all critically ill patients who received RRT in our ICU during a 3 year-period. Our goal was to identify mortality risk factors and if RRT initiation timing had an impact on survival. RRT timing was calculated from the moment the patient was classified as having acute kidney injury in the RIFLE classification. Results A hundred and ten patients received RRT. We identified four independent mortality risk factors: need for mechanical ventilation (OR = 12.82 (1.305 - 125.868, p = 0.0286); RRT initiation timing >16 h (OR = 5.66 (1.954 - 16.351), p = 0.0014); urine output on admission <500 ml/day (OR = 4.52 (1.666 - 12.251), p = 0.003); and SAPS II on admission >70 (OR = 3.45 (1.216 - 9.815), p = 0.02). The RRT initiation <16 h and RRT initiation >16 h groups presented the same baseline characteristics, except for more severe gravity scores and kidney failure in the early RRT group. Conclusions Early RRT in ICU patients with acute kidney injury or failure was associated with increased survival.

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Acute kidney injury in SARS-CoV2-related pneumonia ICU patients: a retrospective multicenter study

Annals of Intensive Care ◽

10.1186/s13613-021-00875-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Guillaume Geri ◽

Michael Darmon ◽

Lara Zafrani ◽

Muriel Fartoukh ◽

Guillaume Voiriot ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Acute Kidney Injury ◽

Kidney Disease ◽

Cox Model ◽

Invasive Mechanical Ventilation ◽

Kidney Injury ◽

Icu Patients ◽

Increased Risk ◽

Stage 1

Abstract Background While acute kidney injury (AKI) is frequent in severe SARS-CoV2-related pneumonia ICU patients, few data are still available about its risk factors. Methods Retrospective observational study performed in four university affiliated hospitals in Paris. AKI was defined according to the KIDGO guidelines. Factors associated with AKI were picked up using multivariable mixed-effects logistic regression. Independent risk factors of day 28 mortality were assessed using Cox model. Results 379 patients (median age 62 [53,69], 77% of male) were included. Half of the patients had AKI (n = 195, 52%) including 58 patients (15%) with AKI stage 1, 44 patients (12%) with AKI stage 2, and 93 patients (25% with AKI stage 3). Chronic kidney disease (OR 7.41; 95% CI 2.98–18.4), need for invasive mechanical ventilation at day 1 (OR 4.83; 95% CI 2.26–10.3), need for vasopressors at day 1 (OR 2.1; 95% CI 1.05–4.21) were associated with increased risk of AKI. Day 28 mortality in the cohort was 26.4% and was higher in patients with AKI (37.4 vs. 14.7%, P < 0.001). Neither AKI (HR 1.35; 95% CI 0.78–2.32) nor AKI stage were associated with mortality (HR [95% CI] for stage 1, 2 and 3 when compared to no AKI of, respectively, 1.02 [0.49–2.10], 1.73 [0.81–3.68] and 1.42 [0.78–2.58]). Conclusion In this large cohort of SARS-CoV2-related pneumonia patients admitted to the ICU, AKI was frequent, mostly driven by preexisting chronic kidney disease and life sustaining therapies, with unclear adjusted relationship with day 28 outcome.

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916 Prevalence, risk factors and outcome of acute kidney injury in hopsitalised children at the JOS university teaching hospital JOS, Plateau state. Nigeria

10.1136/archdischild-2021-rcpch.279 ◽

2021 ◽

Author(s):

Andoka Michael-Asokwu ◽

Isaac Ocheke ◽

Stephen Oguche

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Teaching Hospital ◽

Kidney Injury ◽

University Teaching ◽

Jos Plateau ◽

Plateau State

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A Cross Sectional Study on Risk Factors, Clinical Profile and Aetiology of Acute Pyelonephritis in a Tertiary Teaching Hospital in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/643 ◽

2020 ◽

Vol 7 (52) ◽

pp. 3159-3165

Author(s):

Mohammed Shafi P.K. ◽

Rosh P

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Acute Kidney Injury ◽

Urinary Tract ◽

Teaching Hospital ◽

Acute Pyelonephritis ◽

Kidney Injury ◽

Cross Sectional ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital

BACKGROUND Acute pyelonephritis (APN) is one of the most severe forms of urinary tract infections (UTI) with a higher incidence among females compared to males. Escherichia coli is the commonest causative organism isolated in 80 % of the cases in Kerala. Risk factors like structural or functional abnormalities of urogenital system, immunosuppression, comorbidities and virulence & resistance of microorganism play vital roles in predicting the prognosis. Our aim was to study the prevalence of various risk factors of acute pyelonephritis in adult patients, the clinical profile, aetiological agents and their sensitivity to antibiotics, and related complications on their usage. METHODS In a cross-sectional observational study, 100 adult patients with acute pyelonephritis admitted in a tertiary teaching hospital in Kerala were studied between January 2016 and January 2017. Detailed history and clinical examination were carried out. Complete haemogram, random blood sugar, renal function test, urine culture and sensitivity, and ultrasonogram of abdomen and pelvis were done. RESULTS The most common age group was 40 - 49 years with a male to female ratio of 2:3. Dysuria was observed in 82 % of patients followed by increased frequency of micturition in 65 % and vomiting in 42 %. Diabetes mellitus was observed in 55 % of patients and recurrent UTI in 44 %. Escherichia coli was found in 66 % of patients followed by Klebsiella in 23 %. Culture showed that 85 % of the bacteria were sensitive to piperacillin-tazobactam. 44 % of the patients did not respond to the empirical antibiotic, and the failure rate was higher among those empirically treated with ciprofloxacin. 41 % of the patients developed acute kidney injury, which necessitated haemodialysis in 23 %. 14 % of the patients developed septic shock and the mortality was 10 %. CONCLUSIONS Certain risk factors such as diabetes, hypertension, chronic kidney disease and indwelling catheters were associated with increased incidence of complications. Hence, in presence of such risk factors appropriate treatment and preventive measures should be initiated promptly. Among the pathogens, 85 % of the organisms were sensitive to piperacillin–tazobactam. Hence, piperacillintazobactam can be recommended as the first line empirical antibiotic. KEYWORDS Acute Pyelonephritis, Urinary Tract Infection, Acute Kidney Injury (AKI), and E. coli

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