Epidemiology of Acute Kidney Injury in Moroccan Medical Intensive Care Patients: A Regional Prospective, Observational Study

Abstract

Objective: To evaluate the incidence, mortality and influencing factors for the development of Acute Kidney Injury (AKI) at admission or during Intensive Care Unit (ICU) stay. Methods: We conducted a prospective, epidemiological survey, in ICU for two years and the data of 97 patients admitted to ICU for medical illness was analyzed. Patients with AKI were categorized by serum creatinine and urine output into 3 stages. Stage 1 was defined as an absolute increase (within 48 hours) in serum creatinine of more than or equal to 0.3 mg/dl, or oliguria of less than 0.5ml/kg per hour for more than six hours. Stage 2 was defined as doubling of serum creatinine, or a urinary output lower than 0.5ml/kg /h for 12 h. Stage 3 was defined as tripling of serum creatinine or a urinary output lower than 0.3 ml/kg/h for 24 h, or anuria for 12 h. Results: Sixty patients (62 %) had AKI. AKI patients tended to be older and usually had antecedent of heart disease, a high Simplified Acute Physiology Score version II at admission, more use of mechanical ventilation and vasopressor treatment, more shock, more severe sepsis, more hyperosmolar hyperglycemic state (HHS) and higher mortality. In multivariate analysis, SAPS II score >30, antecedent of heart disease and shock were independent risk factors for development of AKI at admission or during ICU stay. Conclusion: AKI had a high incidence and a high mortality in medical ICU's patients. Antecedent of severe underlying diseases, heart disease and hemodynamic failure were independent risk factors of AKI.

Risk factors and outcomes of acute kidney injury in South African critically ill adults: a prospective cohort study

“…As in other African [29–31] and HI country [1] ICU-based studies, AKI was very common in our cohort and affected nearly two thirds (58.5%) of all patients admitted to the ICU. AKI was associated with male gender, higher severity of illness, more sepsis, longer ICU stay and the need for vasopressors.…”

“…This is the largest prospective African study of AKI in critically ill adults with an HIV seropositive rate of 32.6%. Similar studies include reports from Morocco ( n = 97) [29], the Democratic Republic of Congo (DRC, n = 476) [30] and Egypt ( n = 532) [31]. However, only the DRC study reported HIV prevalence, which was low at 2.9%.…”

“…However, only the DRC study reported HIV prevalence, which was low at 2.9%. Consistent with other LMI countries, patients were younger than in HI country cohorts (mean age 40.6 years) with lower comorbidity rates [1, 18, 19, 29–32], mostly of Black African ethnicity, and were representative of the local community that we serve [21].…”