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Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit

OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between Nove...

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Autores principales: Tejera, Darwin, Varela, Fernanda, Acosta, Daniela, Figueroa, Stephanie, Benencio, Sebastián, Verdaguer, Cristina, Bertullo, Mauricio, Verga, Federico, Cancela, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Medicina Intensiva Brasileira - AMIB 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764556/
https://www.ncbi.nlm.nih.gov/pubmed/29211186
http://dx.doi.org/10.5935/0103-507X.20170061
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author Tejera, Darwin
Varela, Fernanda
Acosta, Daniela
Figueroa, Stephanie
Benencio, Sebastián
Verdaguer, Cristina
Bertullo, Mauricio
Verga, Federico
Cancela, Mario
author_facet Tejera, Darwin
Varela, Fernanda
Acosta, Daniela
Figueroa, Stephanie
Benencio, Sebastián
Verdaguer, Cristina
Bertullo, Mauricio
Verga, Federico
Cancela, Mario
author_sort Tejera, Darwin
collection PubMed
description OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis. There were no interventions. Acute kidney injury was defined according to the criteria set forth in Acute Kidney Injury Disease: Improving Global Outcomes, and chronic kidney disease was defined according to the Chronic Kidney Disease Work Group. RESULTS: We included 401 patients, 56.6% male, median age of 68 years (interquartile range (IQR) 51-79 years). The diagnosis at admission was severe sepsis 36.3%, neurocritical 16.3%, polytrauma 15.2%, and other 32.2%. The incidence of acute kidney injury was 50.1%, and 14.1% of the patients suffered from chronic kidney disease. The incidence of acute septic kidney injury was 75.3%. Mortality in patients with or without acute kidney injury was 41.8% and 14%, respectively (p < 0.001). In the multivariate analysis, the most significant variables for acute kidney injury were chronic kidney disease (odds ratio (OR) 5.39, 95%CI 2.04 - 14.29, p = 0.001), shock (OR 3.94, 95%CI 1.72 - 9.07, p = 0.001), and severe sepsis (OR 7.79, 95%CI 2.02 - 29.97, p = 0.003). CONCLUSION: The incidence of acute kidney injury is high mainly in septic patients. Chronic kidney disease was independently associated with the development of acute kidney injury.
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spelling pubmed-57645562018-01-17 Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit Tejera, Darwin Varela, Fernanda Acosta, Daniela Figueroa, Stephanie Benencio, Sebastián Verdaguer, Cristina Bertullo, Mauricio Verga, Federico Cancela, Mario Rev Bras Ter Intensiva Original Articles OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis. There were no interventions. Acute kidney injury was defined according to the criteria set forth in Acute Kidney Injury Disease: Improving Global Outcomes, and chronic kidney disease was defined according to the Chronic Kidney Disease Work Group. RESULTS: We included 401 patients, 56.6% male, median age of 68 years (interquartile range (IQR) 51-79 years). The diagnosis at admission was severe sepsis 36.3%, neurocritical 16.3%, polytrauma 15.2%, and other 32.2%. The incidence of acute kidney injury was 50.1%, and 14.1% of the patients suffered from chronic kidney disease. The incidence of acute septic kidney injury was 75.3%. Mortality in patients with or without acute kidney injury was 41.8% and 14%, respectively (p < 0.001). In the multivariate analysis, the most significant variables for acute kidney injury were chronic kidney disease (odds ratio (OR) 5.39, 95%CI 2.04 - 14.29, p = 0.001), shock (OR 3.94, 95%CI 1.72 - 9.07, p = 0.001), and severe sepsis (OR 7.79, 95%CI 2.02 - 29.97, p = 0.003). CONCLUSION: The incidence of acute kidney injury is high mainly in septic patients. Chronic kidney disease was independently associated with the development of acute kidney injury. Associação de Medicina Intensiva Brasileira - AMIB 2017 /pmc/articles/PMC5764556/ /pubmed/29211186 http://dx.doi.org/10.5935/0103-507X.20170061 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Tejera, Darwin
Varela, Fernanda
Acosta, Daniela
Figueroa, Stephanie
Benencio, Sebastián
Verdaguer, Cristina
Bertullo, Mauricio
Verga, Federico
Cancela, Mario
Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title_full Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title_fullStr Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title_full_unstemmed Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title_short Epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
title_sort epidemiology of acute kidney injury and chronic kidney disease in the intensive care unit
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764556/
https://www.ncbi.nlm.nih.gov/pubmed/29211186
http://dx.doi.org/10.5935/0103-507X.20170061
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