Acute kidney injury in intensive care patients: Incidence, time course, and risk factors

Abstract

Background Acute kidney injury (AKI) is frequent and influences the prognosis of intensive care unit (ICU) patients. The aim of this study was to estimate the incidence, time‐course, risk factors, and mortality of AKI among unselected ICU patients. Methods All adult ICU patients admitted to the ICU at the University Hospital in Central Norway from 2010 to 2015 with a stay of 24 h or more were included in the study. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. All patients were followed with respect to reversal of AKI. Risk factors for AKI were analyzed using Cox regression. Results Among 2325 ICU patients, 1245 developed AKI during the ICU stay, corresponding to an incidence of 53.5 % (CI, 51.5–55.5). The incidence according to KDIGO AKI stages 1, 2, and 3 was 26.2, 11.7, and 15.7%, respectively. The median duration of AKI was 24 (CI 19–24), 32 (CI 26–39), and 101 (CI 75–164) hours for AKI KDIGO stage 1, 2, and 3, respectively. AKI was transient, persistent, or AKD in 73.4, 16.5, and 10.0% of the patients with a known outcome. AKI reversal was observed in 72.9% of all AKI patients. Independent risk factors for AKI in a multivariate analysis were hypertension, diabetes, heart disease, and higher body weight. Episodes of mean arterial pressure below 73 mmHg were associated with a higher risk of AKI. Conclusions In our material, the incidence of AKI was comparable to what has been reported previously. Risk factors for the development of AKI were a MAP below 73, hypertension, diabetes, heart disease, chronic kidney disease, and higher body weight. Most AKI patients regain their kidney function during the ICU stay, particularly in the KDIGO AKI stages 1 and 2.

The Impact of Recombinant Human Erythropoietin Administration in Critically ill COVID-19 Patients: A Multicenter Cohort Study

“…This could be attributed to the development of liver injury (20.0% vs 6.7%) and the occurrence of acquired infections during the patient's stay. 27,28 In contradiction to our findings, Benjamin et al reported four cases of anemic COVID-19 patients, two were critically ill, and all four patients received EPO analogs, changes from baseline hemoglobin and hematocrit were variable. However, it is good to note that the four patients were smokers in addition to one patient with CKD, which subsequently suggests possible ESA administration pre-COVID-19 infection.…”

“…This could be attributed to the development of liver injury (20.0% vs 6.7%) and the occurrence of acquired infections during the patient's stay. 27 , 28 …”

Incidence and Predictors of Acute Kidney Injury among Patients Admitted to Adult Intensive Care Unit at West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A multicenter retrospective follow-up study

“…In contrast, this nding is lower than the studies conducted in Norway (53.5%) [22], Jordan (31.6%) [23], Iran (37%) [32], Indonesia (43%) [20], Brazil (40.5%) [33], Uruguay(50.1%) [17], Zambia(52.9%) [7] and Sudan (39%) [9]. The reason for this discrepancy might be due to the difference in the characteristics of study population, sampling method, level of study setting, duration of follow-up time, and sample size.…”

“…According to the different studies conducted around the world age greater than sixty, male gender, hypertension, diabetes mellitus, chronic cardiovascular disease, stroke, sepsis, shock, anemia, hypotension, acute respiratory distress syndrome(ARDS), coronary artery disease, and oncologic disease, Human immunode ciency virus (HIV), trauma, major abdominal surgery, high serum creatinine concentration, low platelet level, urea, treatments of ; diuretics, angiotensive converting enzyme inhibitors(ACEIs), non-steroidal anti-in ammatory, gentamicin, and vasopressor drugs, oliguria, low blood pressure, low Glasgow Coma Scale(GCS), high respiration rate, hypoxia, hyperthermia, serum potassium abnormality, and serum sodium abnormality were independent predictors of AKI among patients admitted to intensive care unit [6,7,[16][17][18][19][20][21][22][23].…”

Machine Learning Models for Predicting Acute Kidney Injury in Patients With Sepsis-Associated Acute Respiratory Distress Syndrome

“…In our study, ARDS patients presented a variety of comorbidities (e.g., hypertension, congestive heart failure, and diabetes mellitus), which accounted for renal vulnerability (49,50). The crosstalk between the kidney and heart is also important, and patients with congestive heart failure and hypertension tend to experience AKI due to decreased renal perfusion (51,52). Diabetes mellitus was reported as an independent indicator for postoperative AKI due to increased susceptibility to renal ischemia and reperfusion injury (53).…”