Retrospective Evaluation of the Factors Affecting Etiology and Prognosis of Adult Acute Kidney Injury
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Original Article
P: 216-222
June 2020

Retrospective Evaluation of the Factors Affecting Etiology and Prognosis of Adult Acute Kidney Injury

Med Bull Haseki 2020;58(3):216-222
1. Şemdinli Devlet Hastanesi, İç Hastalıkları Kliniği, Hakkari, Türkiye
2. Bursa Şehir Hastanesi, Nefroloji Kliniği, Bursa, Türkiye
3. Uludağ Üniversitesi Tıp Fakültesi, Nefroloji Anabilim Dalı, Bursa, Türkiye
4. Uludağ Üniversitesi Tıp Fakültesi, Biyoistatistik Bilim Dalı, Bursa, Türkiye
No information available.
No information available
Received Date: 11.02.2019
Accepted Date: 09.01.2020
Publish Date: 17.06.2020
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ABSTRACT

Aim:

Acute kidney injury (AKI) is still an important cause of morbidity and mortality. Several factors are effective in its frequency, etiology, prognosis and mortality. In our study, we aimed to demonstrate the etiology and prognostic factors of AKI.

Methods:

A total of 272 patients diagnosed with AKI, who were hospitalized in the nephrology department between January 2011 and December 2015, were included in the study. In addition to the demographic characteristics of patients, clinical and laboratory findings were evaluated retrospectively.

Results:

Forty-seven point four percent of patients were female and 52.6% were male. The mean age of the patients was 61.6 years, the mean length of hospital stay was 13.3 days, the number of hemodialysis sessions was 1.24 and the mortality rate was 4.8%. The need and number of hemodialysis sessions were significantly higher in older patients (>65 years). The need and number of hemodialysis sessions were higher in the renal AKI group (48.7%, 1.9). The length of hospital-stay was longer and mortality rate was higher in patients with renal AKI compared to the other groups (16.4 days, 8.8%). Mortality rate, length of hospital-stay, and number of hemodialysis sessions were found to be increased significantly in patients with infection (42%).

Conclusion:

Etiology and accompanying infection in AKI are the most important factors affecting mortality. In addition, anemia and advanced age increase the length of hospital stay and the need for hemodialysis.

References

1
Sharfuddin A, Molitoris BA. Acute Kidney Injury. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, editors. Brenner and Rector’s The Kidney. 9th edition. Philadelphia, PA: Elsevier Health Sciences; 2011. p. 1044-99.
2
Mehta RL, Chertow GM. Acute renal failure definitions and classification: time for change? J Am Soc Nephrol 2003;14:2178-87.
3
Molitoris BA, Levin A, Warnock DG, et al. Acute Kidney Injury Network. Improving outcomes from acute kidney injury. J Am Soc Nephrol 2007;18:1992-4.
4
Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31.
5
Kellum JA, Lameire N, Aspelin P, et al. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012;2:1-138.
6
Liaño F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996;50:811-8.
7
Selcuk NY, Odabas AR, Cetinkaya R, et al. Frequency and outcome of patients with acute renal failure have more causes than one in etiology. Ren Fail 2000;22:459-64.
8
Utas C, Yalçındag C, Taşkapan H, et al. Acute renal failure in Central Anatolia. Nephrol Dial Transplant 2000;15:152-5.
9
Zhou J, Yang L, Zhang K, et al. Risk factors for the prognosis of acute kidney injury under the Acute Kidney Injury Network definition: a retrospective, multicenter study in critically ill patients. Nephrology (Carlton) 2012;17:330-7.
10
Pascual J, Liaño F. Causes and prognosis of acute renal failure in the very old. Madrid Acute Renal Failure Study Group. J Am Geriatr Soc 1998;46:721-5.
11
Altintepe L, Yazici R. Toksik Nedenlere Bağlı Akut Böbrek Hasarı. Turkiye Klinikleri J Nephrol-Special Topics 2014;7:37-44.
12
Park WY, Hwang EA, Jang MH, et al. The Risk Factors and Outcome of Acute Kidney Injury in the Intensive Care Units. Korean J Intern Med 2010;25:181-7.
13
San A, Selçuk Y, Tonbul Z, et al. Etiology and prognosis in 438 patients with acute renal failure. Ren Fail 1996;18:593-9.
14
Silveira Santos CGD, Romani RF, Benvenutti R, et al. Acute Kidney Injury in Elderly Population: A Prospective Observational Study. Nephron 2018;138:104-12.
15
Wu B, Li L, Cheng X, et al. Propensity-score-matched evaluation of under-recognition of acute kidney injury and short-term outcomes. Sci Rep 2018 11;8:15171.
16
Mahajan S, Tiwari S, Bhowmik D, et al. Factors affecting the outcome of acute renal failure among the elderly population in India: a hospital based study. Int Urol Nephrol 2006;38:391-6.
17
Wang Y, Cui Z, Fan M. Retrospective analysis on Chinese patients diagnosed with acute renal failure hospitalized during the last decade (1994-2003). Am J Nephrol 2005;25:514-9.
18
Selcuk NY, Odabas AR, Cetinkaya R, et al. Frequency and outcome of patients with acute renal failure have more causes than one in etiology. Ren Fail 2000;22:459-64.
19
Utaş C, Yalçındağ C, Taşkapan H, et al. Acute renal failure in Central Anatolia. Nephrol Dial Transplant 2000;15:152-5.
20
el-Reshaid K, Kapoor M, Johny KV, et al. Acute renal failure in Kuwait—a prospective study. J Trop Med Hyg 1993;96:323-9.
21
Ostermann M, Chang RW. Correlation between parameters at initiation of renal replacement therapy and outcome in patients with acute kidney injury. Crit Care 2009;13:R175.
22
Turney JH, Marshall DH, Brownjohn AM. The evolution of acute renal failure, 1956-1988. Q J Med 1990;74:83-104.
23
San A, Selçuk Y, Tonbul Z, et al. Etiology and prognosis in 438 patients with acute renal failure. Ren Fail 1996;18:593-9.
24
Alexopoulos E, Vakianis P, Kokolina E, et al. Acute renal failure in a medical setting: changing patterns and prognostic factors. Ren Fail 1994;16:273-84.
25
Moore PK, Hsu RK, Liu KD. Management of Acute Kidney Injury: Core Curriculum 2018. Am J Kidney Dis. 2018;72:136-48.
26
Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet 2005;365:417-30.
27
Bruce Molitoris. Acute Kidney Injury. In: Goldman L, Schafer AI, (eds). Goldman’s Cecil Medicine.24th edition. Philadelphia, PA: Elsevier Health Sciences; 2011, p. 756-60.
28
Sawhney S, Beaulieu M, Black C, et al. Predicting kidney failure risk after acute kidney injury among people receiving nephrology clinic care. Nephrol Dial Transplant 2018. doi: 10.1093/ndt/gfy294. [Epub ahead of print]
29
Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005;16:3365-70.
30
Zhou J, Yang L, Zhang K, et al. Risk factors for the prognosis of acute kidney injury under the Acute Kidney Injury Network definition: a retrospective, multicenter study in critically ill patients. Nephrology (Carlton) 2012;17:330-7.
31
Kohli HS, Bhat A, Jairam A, et al. Predictors of mortality in acute renal failure in a developing country: a prospective study. Ren Fail 2007;29:463-9.
32
Yilmaz H, Akçay A. Akut Böbrek Hasarının Etiyoloji ve Fizyopatolojisi. Turkiye Klinikleri J Nephrol-Special Topics 2014;7:7-13.
33
Altintepe L, Yazici R. Toksik Nedenlere Bağlı Akut Böbrek Hasarı. Turkiye Klinikleri J Nephrol-Special Topics 2014;7:37-44.
34
Gunnerson KJ, Saul M, He S, et al. Lactate versus non-lactate metabolic acidosis: a retrospective outcome evaluation of critically ill patients. Crit Care 2006;10:R22.
35
Story DA, Poustie S, Bellomo R. Estimating unmeasured anions in critically ill patients: anion-gap, base-deficit, and strong-iongap. Anaesthesia 2002;57:1109-14.
36
Obialo CI, Okonofua EC, Nzerue MC, et al. Role of hypoalbuminemia and hypocholesterolemia as copredictors of mortality in acute renal failure. Kidney Int 1999;56:1058-63.
37
Owen WF, Lew NL, Liu Y, et al. The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 1993;329:1001-6.
38
Pegues MA, McCrory MA, Zarjou A. C-reactive protein exacerbates renal ischemia-reperfusion injury. Am J Physiol Renal Physiol 2013;304:F1358-65.
39
Gao F, Zhou YJ, Zhu X, et al. C-reactive protein and the risk of contrastinduced acute kidney injury in patients undergoing percutaneous coronary intervention. Am J Nephrol 2011;34:203-10.
40
Ayar Y, Işıktaş Sayılar E, Ersoy A, et al. Akut Böbrek Hasarında Mortalitede Öncül Faktörler. Kocatepe Tıp Dergisi 2015;16:192-7.
41
Zhang H, Zhang L, Li L, et al. Characteristics of hemoglobin changes and its significance in critically ill patients. Zhonghua Wai Ke Za Zhi 2009;47:1221-3.
42
Walsh M, Garg AX, Devereaux PJ, et al. The association between perioperative hemoglobin and acute kidney injury in patients having noncardiac surgery. Anesth Analg 2013;117:924-31.