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Effect of acute kidney injury on mortality and hospital stay in patient with severe acute pancreatitis
Author(s) -
Zhou Jiaojiao,
Li Yi,
Tang Yi,
Liu Fang,
Yu Shaobin,
Zhang Ling,
Zeng Xiaoxi,
Zhao Yuliang,
Fu Ping
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12439
Subject(s) - medicine , acute kidney injury , acute pancreatitis , sepsis , incidence (geometry) , retrospective cohort study , renal replacement therapy , odds ratio , intensive care medicine , etiology , intensive care unit , optics , physics
Aim Severe acute pancreatitis ( SAP ) is believed to be a major risk factor leading to acute kidney injury ( AKI ) among critically ill patients, but little is known about SAP ‐induced AKI . We study the incidence of AKI defined by the A cute K idney I njury N etwork ( AKIN ) criteria and the risk factors associated with outcomes among SAP ‐induced AKI patients. Method We conducted a multicenter retrospective study of critically ill SAP ‐induced AKI patients during the period A ugust 2009 to J une 2013. Data on enrolled patients were retrieved from electronic records. Univariate and multiple regression analyses were performed. Results Among a total of 414 SAP patients admitted to intensive care units( ICU ), 287 (69.3%) developed AKI during their ICU stay, with 16.7%, 18.4%, and 34.3% classified as AKI stage I , II , and III , respectively. SAP ‐induced AKI patients experienced a significantly higher ICU mortality than those without AKI . The risk factors associated with ICU mortality among SAP ‐induced AKI patients included ACS (odds ratio ( OR ) 10.58), RRT ( OR 3.31), sepsis ( OR 2.46), CTSI ( OR 3.01), APACHE II score ( OR 1.82), AKI III ( OR 1.38), ICU ‐length‐of‐stay ( OR 1.04), and multi‐organ failure. Conclusions The paper represents the first attempt to investigate the etiology and epidemiology of AKI following SAP under the AKIN criteria among critically ill patients. Several independent risk factors were found to be associated with ICU mortality for AKI patients. The findings may pinpoint crucial therapeutic measures for preventing AKI among a vulnerable population and for more effective management of SAP ‐induced AKI to improve the quality of intensive care.