Incidences and clinical outcomes of acute kidney injury in ICU: a prospective observational study in Sri Lanka

BMC Research Notes

Senaka Rajapakse¹  Rezvi Sheriff¹  Chaminda Wikramaratne²  Gowri M Ratnayake³  Eranga S Wijewickrama¹ 

[1] Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;Medical Intensive Care Unit, National Hospital, Colombo, Sri Lanka;Colombo South Teaching Hospital, Kalubowila, Sri Lanka

关键词: ICU stay;    Mortality;    Sepsis;    Critical care;    Intensive care;    Acute kidney injury;   

Others  :  1132727
DOI  :  10.1186/1756-0500-7-305

 received in 2013-07-30, accepted in 2014-05-14,  发布年份 2014

【 摘 要 】

Background

Acute kidney injury (AKI) is a common and a serious complication among patients admitted to intensive care units (ICUs), and has been the focus of many studies leading to recent advances in diagnosis and classification. The incidence and outcome of AKI in Sri Lankan ICUs is largely unknown. The aim of this study was to describe the incidence, severity and outcome of AKI among patients admitted to the medical ICU, National Hospital, Colombo, Sri Lanka (NHSL).

Methods

Patients admitted to the medical ICU, NHSL, over a period of 6 months were studied prospectively.

Standard demographic, physiological and clinical data were collected. Severity of illness was assessed using SOFA (Sequential Organ Failure Assessment) score. Diagnosis of AKI was based on Acute Kidney Injury Network (AKIN) criteria.

Results

Of 212 patients screened, 108 satisfied the inclusion criteria; males 67(61.5%); mean age 47.8 years(SD 19.4, range 12-94). Mean duration of ICU stay was 11.6 days (SD 10.6, range 2-55). Eighty one (75.0%) received mechanical ventilation. Forty nine (45.4%) had sepsis. ICU mortality was 38.9% and AKI was present in 60.2%. The majority of AKI patients (38, 58.5%) had AKI stage 3. Patients with AKI were at higher risk of death (p < 0.01). Neither age, gender, nor the presence of co-morbidities were associated with increased risk of AKI. Patients with AKI had significantly longer ICU stay (Log-Rank Chi Square: 23.186, p < 0.0001). Both the incidence of AKI and ICU mortality were higher in patients with SOFA scores over 9 (Pearson Chi-Square 7.581, p = 0.006, and 11.288, p = 0.001 respectively).

Conclusions

The incidence of AKI is high at 60% among our ICU patients, and those with AKI had higher mortality and longer duration of ICU stay. Age, gender or the presence of co-morbidities was not associated with a higher risk of AKI. Patients with SOFA scores over 9 within the first 24 hours were more likely to develop AKI and had higher risk of death.

【 授权许可】

   
2014 Wijewickrama et al.; licensee BioMed Central Ltd.

【 图 表 】

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