Epidemiology of acute kidney injury in intensive care units in Beijing: the multi-center BAKIT study

Abstract

BackgroundAcute kidney injury (AKI) commonly occurs in intensive care units (ICUs), leading to adverse clinical outcomes and increasing costs. However, there are limited epidemiological data of AKI in the critically ill in Beijing, China.MethodsIn this prospective cohort study in 30 ICUs, we screened the patients up to 10 days after ICU admission. Characteristics and outcomes were compared between AKI and non-AKI, renal replacement therapy (RRT) and non-RRT patients. Nomograms of logistic regression and Cox regression were performed to examine potential risk factors for AKI and mortality.ResultsA total of 3107 patients were included in the final analysis. The incidence of AKI was 51.0%; stages 1 to 3 accounted for 23.1, 11.8, and 15.7%, respectively. The majority (87.6%) of patients with AKI developed AKI on the first 4 days after admission to the ICU. A total of 281 patients were treated with RRT. Continuous RRT with predilution, citrate for anticoagulation and femoral vein for vascular access was the most common RRT pattern (29.9%, 84 of 281). Patients with AKI were associated with longer ICU-LOS and higher mortality and costs (P<0.001). In patients treated with RRT, 78.6 and 28.5% of RRTs were dependent on the 7th and 28th days, respectively. The 28 day mortalities of non-AKI, AKI stages 1–3, and septic shock patients were 6.83, 15.04, 27.99, 45.18 and 36.5%, respectively.ConclusionsApproximately half of our ICU patients experienced AKI. The majority of patients with AKI developed AKI during the first 4 days after admission to the ICU. Continuous RRT with predilution, citrate for anticoagulation and femoral vein for vascular access was the most common RRT pattern in our ICUs. AKI was associated with a higher mortality and costs, incomplete kidney recovery and s series of adverse outcomes.

The incidence, risk factors, and outcomes of acute kidney injury in the intensive care unit in Sudan

“…In the current study, the incidence of AKI (39.0%) was less than that reported in a large Chinese cohort study [14] conducted in 30 ICUs where the incidence of AKI was 51.0%. This variation can be attributed to the characteristics differences between the two populations and the criteria used for the classification of AKI.…”

“…The Chinese study has excluded nearly 6000 subjects (3107 participants were included in the final analysis among the 9049 subjects admitted to the participating ICUs during the study period) which might have affected the reported mortality. The incidence of AKI has included stage one (23.1%), stage 2 (11.8%), and stage 3 (15.7%) [14]. However, in our current study, the severity grading of AKI was mainly staged 1 (45.5%) and stage 2 (54.5%).…”

Severe Acute Kidney Injury in Patients with COVID-19 and Acute Respiratory Distress Syndrome

“…A recent large, multicenter epidemiological study (BAKIT [Beijing Acute Kidney Injury Trial] study) conducted in the ICU showed that KDIGO stage 3 AKI accounted for 16% of critically ill patients ( 7 ). This incidence was 15% in a secondary analysis of the LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study ( 8 ).…”

Acute Kidney Injury in Septic Patients Treated by Selected Nephrotoxic Antibiotic Agents—Pathophysiology and Biomarkers—A Review

“…The incidence of AKI in these circumstances, predominantly in situations with presentation of septic shock, may be as high as 47.5% and the overall mortality in critically ill patients with AKI may be more than 60% [ 3 ]. According to recent results of a multicenter Chinese study of patients hospitalized in ICUs, the incidence of AKI was 51%, with the majority occurring on the 4th day after admission [ 4 ]. A number of factors can contribute to AKI and progression to renal failure, including cardiovascular and hepatic disorders, malignancies, hypovolemia, intoxication, drug nephrotoxicity, anemia and surgical and vascular interventions.…”