Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

Nisula, Sara; Kaukonen, Kirsi‐Maija; Vaara, Suvi T.; Korhonen, Anna‐Maija; Poukkanen, Meri; Karlsson, Sari; Haapio, Mikko; Inkinen, Outi; Parviainen, Ilkka; Suojaranta-Ylinen, Raili; Laurila, Jouko; Tenhunen, Jyrki; Reinikainen, Matti; Ala‐Kokko, Tero; Ruokonen, Esko; Kuitunen, Anne; Pettilä, Ville

doi:10.1007/s00134-012-2796-5

Cited by 387 publications

(365 citation statements)

References 26 publications

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“…Seven observational studies251, 252, 253, 254, 255, 256, 257 examining patient mortality rate as a clinical outcome were extracted during an assessment comparing the KDIGO guidelines and the AKIN and RIFLE criteria, and as a result of comparing AKI diagnoses based on the KDIGO guidelines with diagnoses based on the RIFLE or AKIN criteria, diagnoses based on the AKIN criteria were found to have higher accuracy or were reflective of similar in‐hospital mortality rates. Although only the study by Peng et al 257.…”

Section: Cq12: Acute Kidney Injury/blood Apheresismentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Cq12: Acute Kidney Injury/blood Apheresismentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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“…The main known risk factors for AKI in critically ill patients are absolute or relative hypovolemia, nephrotoxic drug exposure, sepsis, and comorbidities (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

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Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, & measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays .24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3% of patients and was more common in patients with ARDS (44.3% versus 27.4% in patients without ARDS; P,0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2% (n=1140) and was higher in patients with ARDS (27.9% versus 10.0% in patients without ARDS; P,0.001) and in patients with AKI (27.6% versus 8.1% in those without AKI; P,0.001). AKI was associated with higher mortality in patients with ARDS (42.3% versus 20.2%; P,0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.

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“…Up to 40 % of critically ill patients will develop an acute kidney injury (AKI) [1]. This renal complication is associated with high morbidity, high short-term and longterm mortality and a tremendous economic impact [1,2].…”

Section: Akimentioning

confidence: 99%

“…This renal complication is associated with high morbidity, high short-term and longterm mortality and a tremendous economic impact [1,2]. Prevention and treatment of AKI mainly rely on hemodynamic optimization and avoidance of nephrotoxic agents [3].…”

Section: Akimentioning

confidence: 99%

Biomarkers for AKI improve clinical practice: yes

Legrand

Darmon

2014

Intensive Care Med

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Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

Abstract: The incidence of AKI in the critically ill in Finland was comparable to previous large multi-centre ICU studies. Hospital mortality (26 %) in AKI patients appeared comparable to or lower than in other studies.

Cited by 387 publications

References 26 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Biomarkers for AKI improve clinical practice: yes

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