Diagnostics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm

Thongprayoon, Charat; Hansrivijit, Panupong; Kovvuru, Karthik; Kanduri, Swetha R; Torres‐Ortiz, Aldo; Acharya, Prakrati; Suarez, M; Kaewput, Wisit; Bathini, Tarun; Cheungpasitporn, Wisit

doi:10.3390/jcm9041104

Cited by 49 publications

(47 citation statements)

References 192 publications

(175 reference statements)

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“…Second, we could not conclude whether acute kidney injury was the cause or consequence of other complications in heat stroke patients. Third, the diagnosis of acute kidney injury in this study was only based on ICD codes, and not on kidney function parameters (e.g., serum creatinine and urine output) [28]. The diagnosis of acute kidney injury on the basis of diagnosis code has low sensitivity and tends to miss mild acute kidney injury [10,11].…”

Section: Discussionmentioning

confidence: 96%

Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States

et al. 2020

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This study aims to evaluate the risk factors and the association of acute kidney injury with treatments, complications, outcomes, and resource utilization in patients hospitalized for heat stroke in the United States. Hospitalized patients from years 2003 to 2014 with a primary diagnosis of heat stroke were identified in the National Inpatient Sample dataset. End stage kidney disease patients were excluded. The occurrence of acute kidney injury during hospitalization was identified using the hospital diagnosis code. The associations between acute kidney injury and clinical characteristics, in-hospital treatments, outcomes, and resource utilization were assessed using multivariable analyses. A total of 3346 hospital admissions were included in the analysis. Acute kidney injury occurred in 1206 (36%) admissions, of which 49 (1.5%) required dialysis. The risk factors for acute kidney injury included age 20–39 years, African American race, obesity, chronic kidney disease, congestive heart failure, and rhabdomyolysis, whereas age <20 or ≥60 years were associated with lower risk of acute kidney injury. The need for mechanical ventilation and blood transfusion was higher when acute kidney injury occurred. Acute kidney injury was associated with electrolyte and acid-base derangements, sepsis, acute myocardial infarction, ventricular arrhythmia or cardiac arrest, respiratory, circulatory, liver, neurological, hematological failure, and in-hospital mortality. Length of hospital stay and hospitalization cost were higher in acute kidney injury patients. Approximately one third of heat stroke patients developed acute kidney injury during hospitalization. Acute kidney injury was associated with several complications, and higher mortality and resource utilization.

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Section: Discussionmentioning

confidence: 96%

Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States

et al. 2020

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“…Not suprizingly, baseline chronic kidney disease has always been considered the risk factor for developing AKI. 19 Moreover, the lower eGFR was associated with the higher risk of AKI. 20 The reduction of renal reserve due to precipitating factors, such as hypotension, hypovolemia, use of nephrotoxic agents, is the probable explainion of chronic kidney disease patients being at risk for AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury among Salicylate Intoxication Hospitalizations in the United States

Petnak

Kaewput

Qureshi

et al. 2020

Preprint

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Background: This study aimed to evaluate the risk factors and the association of acute kidney injury (AKI) with outcomes, and resource utilization in patients hospitalized due to salicylate intoxication in the United States. Methods: Hospitalized patients with a primary diagnosis of salicylate intoxication from 2003 to 2014 were identified in the National Inpatient Sample (NIS) database. End-stage kidney disease patients were excluded. The occurrence of AKI was identified using hospital diagnosis code. Clinical characteristics, in-hospital treatment, outcomes and resource utilization were compared between patients with and without AKI. Results: A total of 13,787 eligible hospital admissions were included in the analysis. AKI occurred in 1,279 (9.3%) admissions. Older age, male sex, more recent year of hospitalization, anemia, hypertension, congestive heart failure, chronic kidney disease, volume depletion, sepsis, and ventricular arrhythmia/cardiac arrest were significantly associated with increased risk of AKI, whereas Hispanic race was associated with decreased risk. AKI was significantly associated with increased risk of organ failure, and in-hospital mortality. In addition, the need for ventilation support, blood component transfusion, renal replacement therapy, length of hospital stay, and hospitalization cost were higher in AKI patients. Conclusion: Approximately one tenth of salicylate intoxication patients developed AKI during hospitalization. AKI was associated with higher morbidity, mortality, and resource utilizations. What's already known about this topic? Acute kidney injury has been reported as a complication of salicylate intoxication. What does this article add? • Acute kidney injury occurred in about 9% of hospitalization for salicylate intoxication. • Several clinical characteristics were identified as risk factors for acute kidney injury. • Acute kidney injury was associated with higher morbidity, mortality, and resource utilization.

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“…These markers reflect different stages of the pathophysiology of AKI, so, the use of a panel of several biomarkers covering different phases of this syndrome might provide a better early diagnostic tool for AKI, as well as providing targets for future treatments [ 27 , 28 , 30 , 32 , 33 , 34 , 35 ].…”

Section: Diagnosis Of Akimentioning

confidence: 99%

Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies

Gameiro

Fonseca

Outerelo

et al. 2020

JCM

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Acute kidney injury (AKI) is characterized by an acute decrease in renal function that can be multifactorial in its origin and is associated with complex pathophysiological mechanisms. In the short term, AKI is associated with an increased length of hospital stay, health care costs, and in-hospital mortality, and its impact extends into the long term, with AKI being associated with increased risks of cardiovascular events, progression to chronic kidney disease (CKD), and long-term mortality. Given the impact of the prognosis of AKI, it is important to recognize at-risk patients and improve preventive, diagnostic, and therapy strategies. The authors provide a comprehensive review on available diagnostic, preventive, and treatment strategies for AKI.

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Diagnostics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm

Cited by 49 publications

References 192 publications

Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States

Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States

Acute Kidney Injury among Salicylate Intoxication Hospitalizations in the United States

Acute Kidney Injury: From Diagnosis to Prevention and Treatment Strategies

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