Nephron
Clinical Practice: Original Paper
Community Acquired Acute Kidney Injury in Mansoura Nephrology Dialysis Unit: One Year Prospective Observational StudyAbdelsalam M. · Elnagar S.S.E. · Mohamed A.H. · Tawfik M. · Sayed Ahmed N.Department of Internal Medicine, Nephrology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Article / Publication Details
Received: March 07, 2018
Accepted: July 12, 2018
Published online: September 11, 2018
Issue release date: October 2018
Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 7
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
Abstract
Aim: Acute kidney injury (AKI) is a major health problem with poor patient prognosis. We evaluated the clinical characteristics, risk factors, associated comorbidities, and outcomes of AKI patients. Methodology: A single-center prospective observational study. The patients were admitted in Mansoura Nephrology and Dialysis Unit over a period of 1 year from January to December, 2016. Patients were diagnosed as AKI or AKI in addition to chronic kidney disease according to the creatinine criteria of KDIGO 2013. All patients were subjected to complete history taking, physical examination, and full laboratory and pelvi-abdominal ultrasound investigations. The study outcomes were all-cause hospital mortality, and recovery of renal function. Predictors of mortality were assessed using multivariate logistic regression analysis. The study was reviewed and approved by local Ethical Committee of IBR. Results: We evaluated 199 (96 males plus 103 females) aged between 18 and 88 years old. Dehydration was the commonest precipitating factor for AKI in our patients (68.8%) and Oliguria was the commonest symptom present in 47.7% of patients. Intravenous fluids were received by 79.9% of patients, 22.6% of patients received diuretics, and 33.7% received renal replacement therapy in the form of intermittent hemodialysis. Death occurred in 25 patients (13.16%) and 69 (36.32%) showed no renal recovery. Shock and sepsis were the most significant predictors of mortality. Conclusion: Community acquired AKI is a major health problem with high morbidity and mortality.
© 2018 S. Karger AG, Basel
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References
-
Lewington AJ, Cerdá J, Mehta RL: Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int 2013; 84: 457–467.
-
Schissler MM, Zaidi S, Kumar H, Deo D, Brier ME, McLeish KR: Characteristics and outcomes in community-acquired versus hospital-acquired acute kidney injury. Nephrology 2013; 18: 183–187.
-
Ponce D, Balbi A: Acute kidney injury: risk factors and management challenges in developing countries. Int J Nephrol Renovasc Dis 2016; 9: 193–200.
-
Talaat A, Elshahawy E, El Hammady AM, El-Assal M, Abdullah S: Epidemiology, clinical characteristics and outcome of acute kidney injury in intensive care units in Egyptian patients. Life Sci J 2014; 11: 220–224.
-
Mohamed H, Mukhtar A, Mostafa S, Wageh S, Eladawy A, Zaghlol A, Hasanin A, Hosni M, Farrag M, Botros M, Farok M, Lotfi A: Epidemiology of acute kidney injury in surgical intensive care at University Hospital in Egypt. A prospective observational study. Egypt J Anaesth 2013; 29: 413–417.
-
Melamed A, Sorvillo FJ: The burden of sepsis-associated mortality in the United States from 1999 to 2005: an analysis of multiple-cause-of-death data. Crit Care 2009; 13:R28.
-
Cole L, Bellomo R, Silvester W, Reeves JH: A prospective, multicenter study of the epidemiology, management, and outcome of severe acute renal failure in a “closed” ICU system. Am J Resp Crit Care Med 2000; 162: 191–196.
-
Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W, Macleod A: Incidence and outcomes in acute kidney injury: a comprehensive population-based study. JASN 2007; 18: 1292–1298.
-
Mehta RL, Burdmann E A, Cerdá J, Feehally J, Finkelstein F, García-García G, et al: Recognition and management of acute kidney injury in the International Society of Nephrology 0by25 Global Snapshot: a multinational cross-sectional study. Lancet 2016; 387: 2017–2025.
-
Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al: Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005; 294: 813–818.
-
Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, et al: Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol 2007; 2: 431–439.
-
Bucuvic EM, Ponce D, Balbi AL: Risk factors for mortality in acute kidney injury. Rev Assoc Med Bras 2011; 57: 156–161.
-
Wijewickrama ES, Ratnayake GM, Wikramaratne C, Sheriff R, Rajapakse S: Incidences and clinical outcomes of acute kidney injury in ICU: a prospective observational study in Sri Lanka. BMC Res Notes 2014; 7: 305.
-
Liano F, Pascual J: Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney int 1996; 50: 811–818.
-
Schwilk B, Wiedeck H, Stein B, Reinelt H, Treiber H, Bothner U: Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care. Intensive Care Med 1997; 23: 1204–1211.
-
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW: Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. JASN 2005; 16: 3365–3370.
-
Van Den Noortgate N, Mouton V, Lamot C, Van Nooten G, Dhondt A, Vanholder R, et al: Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference? Nephrol Dial Transplant 2003; 18: 732–736.
-
Cosentino F, Chaff C, Piedmonte M: Risk factors influencing survival in ICU acute renal failure. Nephrol Dial Transplant 1994; 9: 179–182.
-
Mehta RL, Cerdá J, Burdmann EA, Tonelli M, García-García, G, Jha V, et al: International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 2015; 385: 2616–2643.
-
Lombardi R, Yu L, Younes-Ibrahim M, Schor N, Burdmann EA: Epidemiology of acute kidney injury in Latin America. Semin Nephrol 2008; 28: 320–329.
-
Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. NEJM 2003; 348: 1546–1554.
-
Dombrovskiy VY, Martin AA, Sunderram J, Paz HL: Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Criti Care Med 2007; 35: 1244–1250.
-
Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, et al: Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int 2004; 66: 1613–1621.
-
Balbi AL, Gabriel DP, Barsante RC, Caramori JT, Martin LC, Barreti P: Assessment of mortality and specific index in acute renal failure. Rev Assoc Med Bras 2005; 51: 318–322.
-
Lo LJ, Go AS, Chertow GM, McCulloch CE, Fan D, Ordoñez JD, et al: Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease. Kidney Int 2009; 76: 893–899.
-
Magden K, Yildirim I, Kutu M, Ozdemir M, Peynir S, Altas A, et al: Recovery process in patients followed-up due to acute kidney injury. Hippokratia 2013; 17: 239.
Article / Publication Details
Received: March 07, 2018
Accepted: July 12, 2018
Published online: September 11, 2018
Issue release date: October 2018
Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 7
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
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