Epidemiological study of hospital acquired acute kidney injury in critically ill and its effect on the survival

Sci Rep. 2024 Nov 15;14(1):28129. doi: 10.1038/s41598-024-79533-6.

Abstract

In the intensive care unit (ICU), acute kidney injury (AKI) is the most common cause of morbidity and mortality. Hospital-acquired acute kidney injury (HAAKI) is AKI developing after 48 h. We aimed to study the development of AKI and its associated risk factors. We conducted a longitudinal observational study. Inclusion criteria were patients > 18 years of age admitted to ICU. The primary outcome was the development of AKI as defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria. A total of 273 patients were included in the study. Out of 273, 44(16.11%) patients developed AKI. The mean age was 45.80(17.39) years, and 60.81% were males. The median acute physiology and chronic health evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 12(8-18) and 5(3-7), respectively. Diabetes mellitus (23.44%) and hypertension (23.81%) were predominant comorbidities. The risk factors associated with AKI were serum chloride level, colistin, invasive ventilation, positive end-expiratory pressure (PEEP), and fluid balance. The hospital mortality was significantly higher in patients with AKI (43.18%) as compared with no AKI (14.41%). Among the secondary outcomes, 7 (15.90%) patients required renal replacement therapy (RRT) during hospitalisation. The length of ICU stay was higher in patients with AKI 8(5-13) compared to no AKI 5(3-8). A total of 16.11% developed HAAKI, and mortality was 43.18%. Post 6 months follow-up of AKI patients, mortality was 23%. Among survivors none of the patients were on RRT.Patients admitted with normal kidney function can develop AKI. Hence, careful monitoring of ICU patients is necessary.

Keywords: Acute Kidney Injury; Critically ill; HAAKI; KDIGO; Renal Replacement Therapy; Sepsis.

Publication types

  • Observational Study

MeSH terms

  • APACHE
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / mortality
  • Acute Kidney Injury* / therapy
  • Adult
  • Aged
  • Critical Illness* / mortality
  • Female
  • Hospital Mortality*
  • Humans
  • Intensive Care Units*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Organ Dysfunction Scores
  • Risk Factors