What is the real impact of acute kidney injury?

BMC Nephrology

Christopher KT Farmer¹  Toby WK Wheeler¹  Paul E Stevens¹  Michael Bedford¹ 

[1] Kent Kidney Research Group, East Kent Hospitals University NHS Foundation Trust, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent CT1 3NG, UK

关键词: General hospital;    Outcomes;    Impact;    Incidence;    AKI;   

Others  :  1082667
DOI  :  10.1186/1471-2369-15-95

 received in 2013-10-07, accepted in 2014-06-04,  发布年份 2014

【 摘 要 】

Background

Acute kidney injury (AKI) is a common clinical problem. Studies have documented the incidence of AKI in a variety of populations but to date we do not believe the real incidence of AKI has been accurately documented in a district general hospital setting.

The aim here was to describe the detected incidence of AKI in a typical general hospital setting in an unselected population, and describe associated short and long-term outcomes.

Methods

A retrospective observational database study from secondary care in East Kent (adult catchment population of 582,300). All adult patients (18 years or over) admitted between 1^st February 2009 and 31^st July 2009, were included. Patients receiving chronic renal replacement therapy (RRT), maternity and day case admissions were excluded. AKI was defined by the acute kidney injury network (AKIN) criteria. A time dependent risk analysis with logistic regression and Cox regression was used for the analysis of in-hospital mortality and survival.

Results

The incidence of AKI in the 6 month period was 15,325 pmp/yr (adults) (69% AKIN1, 18% AKIN2 and 13% AKIN3). In-hospital mortality, length of stay and ITU utilisation all increased with severity of AKI. Patients with AKI had an increase in care on discharge and an increase in hospital readmission within 30 days.

Conclusions

This data comes closer to the real incidence and outcomes of AKI managed in-hospital than any study published in the literature to date. Fifteen percent of all admissions sustained an episode of AKI with increased subsequent short and long term morbidity and mortality, even in those with AKIN1. This confers an increased burden and cost to the healthcare economy, which can now be quantified. These results will furnish a baseline for quality improvement projects aimed at early identification, improved management, and where possible prevention, of AKI.

【 授权许可】

   
2014 Bedford et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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