Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational studyReportar como inadecuado




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BMC Nephrology

, 12:43

First Online: 13 September 2011Received: 11 September 2010Accepted: 13 September 2011

Abstract

BackgroundDespite the substantial progress in the quality of critical care, the incidence and mortality of acute kidney injury AKI continues to rise during hospital admissions. We conducted a national, multicenter, prospective, epidemiological survey to evaluate the importance of AKI in intensive care units ICUs in Hungary. The objectives of this study were to determine the incidence of AKI in ICU patients; to characterize the differences in aetiology, illness severity and clinical practice; and to determine the influencing factors of the development of AKI and the patients- outcomes.

MethodsWe analysed the demographic, morbidity, treatment modality and outcome data of patients n = 459 admitted to ICUs between October 1, 2009 and November 30, 2009 using a prospectively filled in electronic survey form in 7 representative ICUs.

ResultsThe major reason for ICU admission was surgical in 64.3% of patients and medical in the remaining 35.7%. One-hundred-twelve patients 24.4% had AKI. By AKIN criteria 11.5% had Stage 1, 5.4% had Stage 2 and 7.4% had Stage 3. In 44.0% of patients, AKI was associated with septic shock. Vasopressor treatment, SAPS II score, serum creatinine on ICU admission and sepsis were the independent risk factors for development of any stage of AKI. Among the Stage 3 patients 34 50% received renal replacement therapy. The overall utilization of intermittent renal replacement therapy was high 64.8%. The overall in-hospital mortality rate of AKI was 49% 55-112. The ICU mortality rate was 39.3% 44-112. The independent risk factors for ICU mortality were age, mechanical ventilation, SOFA score and AKI Stage 3.

ConclusionsFor the first time we have established the incidence of AKI using the AKIN criteria in Hungarian ICUs. Results of the present study confirm that AKI has a high incidence and is associated with high ICU and in-hospital mortality.

AbbreviationsADQIAcute Dialysis Quality Initiative

AKIacute kidney injury

AKINacute kidney injury network

CRRTcontinuous renal replacement therapy

CVVHDFcontinuous veno-venous hemodiafiltration

ICUintensive care unit

IHDintermittent hemodialysis

IRRTintermittent renal replacement therapy

RRTrenal replacement therapy

SAPS IIsimplified acute physiology score

SOFAsepsis-related organ failure assessment

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2369-12-43 contains supplementary material, which is available to authorized users.

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Autor: Laszlo Medve - Csaba Antek - Balazs Paloczi - Szilvia Kocsi - Bela Gartner - Zsuzsanna Marjanek - Gabor Bencsik - Peter Ka

Fuente: https://link.springer.com/







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