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...
Autores principales: | , , , , , , , , |
---|---|
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 |