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The Frequency and Outcome of Acute Kidney Injury in a Tertiary Hospital: Which Factors Affect Mortality?
Author(s) -
Ulusoy Sukru,
Arı Derya,
Ozkan Gulsum,
Cansız Muammer,
Kaynar Kubra
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12449
Subject(s) - medicine , acute kidney injury , oliguria , rifle , incidence (geometry) , intensive care unit , renal function , creatinine , mortality rate , guideline , kidney disease , physics , archaeology , pathology , optics , history
Acute kidney injury ( AKI ) is a major cause of mortality and morbidity in hospitalized patients. Incidence and mortality rates vary from country to country, and according to different in‐hospital monitoring units and definitions of AKI . The aim of this study was to determine factors affecting frequency of AKI and mortality in our hospital. We retrospectively evaluated data for 1550 patients diagnosed with AKI and 788 patients meeting the K idney D isease: I mproving G lobal O utcomes ( KDIGO ) guideline AKI criteria out of a total of 174 852 patients hospitalized in our institution between J anuary 1, 2007 and D ecember 31, 2012. Staging was performed based on KDIGO C linical P ractice for A cute K idney I njury and RIFLE ( R isk, I njury, F ailure, L oss of kidney function and E nd‐stage renal failure). Demographic and biochemical data were recorded and correlations with mortality were assessed. The frequency of AKI in our hospital was 0.9%, with an in‐hospital mortality rate of 34.6%. At multivariate analysis, diastolic blood pressure ( OR 0.89, 95% CI 0.87–0.92; P < 0.001), monitoring in the intensive care unit ( OR 0.18, 95% CI 0.09–0.38; P < 0.001), urine output ( OR 4.00, 95% CI 2.03–7.89; P < 0.001), duration of oliguria ( OR 1.51, 95% CI 1.34–1.69; P < 0.001), length of hospitalization ( OR 0.83, 95% CI 0.79–0.88; P < 0.001), dialysis requirement ( OR 2.30, 95% CI 1.12–4.71; P < 0.05), APACHE II score ( OR 1.16, 95% CI 1.09–1.24; P < 0.001), and albumin level ( OR 0.32, 95% CI 0.21–0.50; P < 0.001) were identified as independent determinants affecting mortality. Frequency of AKI and associated mortality rates in our regional reference hospital were compatible with those in the literature. This study shows that KDIGO criteria are more sensitive in determining AKI . Mortality was not correlated with staging based on RIFLE or KDIGO . Nonetheless, our identification of urine output as one of the independent determinants of mortality suggests that this parameter should be used in assessing the correlation between staging and mortality.