Cargando…

Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study

BACKGROUND: Despite the substantial progress in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise during hospital admissions. We conducted a national, multicenter, prospective, epidemiological survey to evaluate the importance of AKI in intensiv...

Descripción completa

Detalles Bibliográficos
Autores principales: Medve, Laszlo, Antek, Csaba, Paloczi, Balazs, Kocsi, Szilvia, Gartner, Bela, Marjanek, Zsuzsanna, Bencsik, Gabor, Kanizsai, Peter, Gondos, Tibor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182967/
https://www.ncbi.nlm.nih.gov/pubmed/21910914
http://dx.doi.org/10.1186/1471-2369-12-43
_version_ 1782212957064658944
author Medve, Laszlo
Antek, Csaba
Paloczi, Balazs
Kocsi, Szilvia
Gartner, Bela
Marjanek, Zsuzsanna
Bencsik, Gabor
Kanizsai, Peter
Gondos, Tibor
author_facet Medve, Laszlo
Antek, Csaba
Paloczi, Balazs
Kocsi, Szilvia
Gartner, Bela
Marjanek, Zsuzsanna
Bencsik, Gabor
Kanizsai, Peter
Gondos, Tibor
author_sort Medve, Laszlo
collection PubMed
description BACKGROUND: Despite the substantial progress in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise during hospital admissions. We conducted a national, multicenter, prospective, epidemiological survey to evaluate the importance of AKI in intensive care units (ICUs) in Hungary. The objectives of this study were to determine the incidence of AKI in ICU patients; to characterize the differences in aetiology, illness severity and clinical practice; and to determine the influencing factors of the development of AKI and the patients' outcomes. METHODS: We analysed the demographic, morbidity, treatment modality and outcome data of patients (n = 459) admitted to ICUs between October 1(st), 2009 and November 30(th), 2009 using a prospectively filled in electronic survey form in 7 representative ICUs. RESULTS: The major reason for ICU admission was surgical in 64.3% of patients and medical in the remaining 35.7%. One-hundred-twelve patients (24.4%) had AKI. By AKIN criteria 11.5% had Stage 1, 5.4% had Stage 2 and 7.4% had Stage 3. In 44.0% of patients, AKI was associated with septic shock. Vasopressor treatment, SAPS II score, serum creatinine on ICU admission and sepsis were the independent risk factors for development of any stage of AKI. Among the Stage 3 patients (34) 50% received renal replacement therapy. The overall utilization of intermittent renal replacement therapy was high (64.8%). The overall in-hospital mortality rate of AKI was 49% (55/112). The ICU mortality rate was 39.3% (44/112). The independent risk factors for ICU mortality were age, mechanical ventilation, SOFA score and AKI Stage 3. CONCLUSIONS: For the first time we have established the incidence of AKI using the AKIN criteria in Hungarian ICUs. Results of the present study confirm that AKI has a high incidence and is associated with high ICU and in-hospital mortality.
format Online
Article
Text
id pubmed-3182967
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-31829672011-09-30 Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study Medve, Laszlo Antek, Csaba Paloczi, Balazs Kocsi, Szilvia Gartner, Bela Marjanek, Zsuzsanna Bencsik, Gabor Kanizsai, Peter Gondos, Tibor BMC Nephrol Research Article BACKGROUND: Despite the substantial progress in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise during hospital admissions. We conducted a national, multicenter, prospective, epidemiological survey to evaluate the importance of AKI in intensive care units (ICUs) in Hungary. The objectives of this study were to determine the incidence of AKI in ICU patients; to characterize the differences in aetiology, illness severity and clinical practice; and to determine the influencing factors of the development of AKI and the patients' outcomes. METHODS: We analysed the demographic, morbidity, treatment modality and outcome data of patients (n = 459) admitted to ICUs between October 1(st), 2009 and November 30(th), 2009 using a prospectively filled in electronic survey form in 7 representative ICUs. RESULTS: The major reason for ICU admission was surgical in 64.3% of patients and medical in the remaining 35.7%. One-hundred-twelve patients (24.4%) had AKI. By AKIN criteria 11.5% had Stage 1, 5.4% had Stage 2 and 7.4% had Stage 3. In 44.0% of patients, AKI was associated with septic shock. Vasopressor treatment, SAPS II score, serum creatinine on ICU admission and sepsis were the independent risk factors for development of any stage of AKI. Among the Stage 3 patients (34) 50% received renal replacement therapy. The overall utilization of intermittent renal replacement therapy was high (64.8%). The overall in-hospital mortality rate of AKI was 49% (55/112). The ICU mortality rate was 39.3% (44/112). The independent risk factors for ICU mortality were age, mechanical ventilation, SOFA score and AKI Stage 3. CONCLUSIONS: For the first time we have established the incidence of AKI using the AKIN criteria in Hungarian ICUs. Results of the present study confirm that AKI has a high incidence and is associated with high ICU and in-hospital mortality. BioMed Central 2011-09-13 /pmc/articles/PMC3182967/ /pubmed/21910914 http://dx.doi.org/10.1186/1471-2369-12-43 Text en Copyright ©2011 Medve et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Medve, Laszlo
Antek, Csaba
Paloczi, Balazs
Kocsi, Szilvia
Gartner, Bela
Marjanek, Zsuzsanna
Bencsik, Gabor
Kanizsai, Peter
Gondos, Tibor
Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title_full Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title_fullStr Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title_full_unstemmed Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title_short Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study
title_sort epidemiology of acute kidney injury in hungarian intensive care units: a multicenter, prospective, observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182967/
https://www.ncbi.nlm.nih.gov/pubmed/21910914
http://dx.doi.org/10.1186/1471-2369-12-43
work_keys_str_mv AT medvelaszlo epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT antekcsaba epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT paloczibalazs epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT kocsiszilvia epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT gartnerbela epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT marjanekzsuzsanna epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT bencsikgabor epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT kanizsaipeter epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy
AT gondostibor epidemiologyofacutekidneyinjuryinhungarianintensivecareunitsamulticenterprospectiveobservationalstudy