INJÚRIA RENAL AGUDA: ESTUDO DE 179 CASOS INTERNADOS NO HOSPITAL DE CLÍNICAS DA UNIVERSIDADE FEDERAL DO PARANÁ (UFPR)

Background: The acute kidney injury (AKI) is characterized by an abrupt decline of the glomerular filtration and it is a frequent complication observed in patients who are admitted in tertiary hospitals. Objectives: This study aimed to evaluate the epidemiology, the main etiologies and the outcome of patients with AKI admitted at the Hospital de Clinicas (UFPR) (Universidade Federal do Parana). Methods: A retrospective study was performed based on records of 179 individuals with diagnosis of AKI, defined according to the AKIN classification, attended at HC/UFPR between January and December of 2010. The registers of laboratory and clinic data of these patients were analyzed. Results: there were 179 patients who were diagnosed with AKI.  The mean age of the whole cohort was 57,3 years. Ninety eight patients (55%) were diagnosed with presumable intrinsic AKI, 72 patients (40%) with pre-renal failure and 9 with post-renal failure (5%). According to the AKIN classification, 36 patients were classified in stage 1 (20,1%), 38 stage 2 (58,6%) and 105 stage 3 (58,6%). Eighty two patients (45%) were treated with renal replacement therapy (RRT).  Among the dialytic patients, the average length of the treatment was 10,7 days, and the overall mortality of 56,8%.Twelve patients (14,8%) remained in RRT after discharge. The mortality was significantly higher among the dialytic patients when compared to the non-dialytic group (26,3% vs. 12,3%, p<0.0001). Conclusions: Intrinsic AKI was the most prevalent form of reported AKI. The mortality was increased in individuals submitted to RRT, and especially among those classified as AKIN 2 and 3. Therefore, the early diagnosis of AKI seems to be an important strategy in the management of AKI in individuals admitted to a tertiary hospital.