TV: Adding insult to injury

sarb.be

2014

Title:What is the real impact of acute kidney injury? Outcomes in a typical general hospital setting. A retrospective observational database study

Deutsches Ärzteblatt international, 2019

International Journal Of Medical Science And Clinical Invention, 2016

Acute Kidney Injury (AKI), earlier termed Acute Renal Failure, is a very common entity affecting patients suffering from a wide variety of illnesses. It refers to a clinical entity characterized by a rapid decrease in renal excretory function with increase in levels of urea and creatinine and decreased urine output. In the initial stages of aki these patients can be easily managed. However, AKI in the setting of multiple co-morbidities is very difficult to manage and is a potentially fatal complication. This study was conducted to analyse the incidence, types, etiological factors, management protocol and mortality secondary to AKI in a in tertiary care hospital. 172 patients admitted in the hospital were included in the study. Patients were selected if their serum creatinine level on the day of admission was more than 1.5 times of the baseline serum creatinine or the urine output was less than 0.5 ml/kg/h for 6 h or the GFR was less than 25 % from the baseline. Patients were classified as pre-renal, renal or post-renal AKI based on history, clinical findings and investigation results. Out of 172 patients with AKI, 35 patients had chronic kidney disease. Infection accounted for 48.8% of all cases followed by volume loss (17.4%) and drugs (12%). Other important causes were altered renal hemodynamics (6.3%), and obstructive uropathy (4%). Pre-renal cause accounted for 84 cases, Renal cause for 79 cases and Post-renal cause for 7 cases. Out of 172 patients, 83 belonged to the Risk category, 57 developed Kidney Injury and 32 developed kidney failure. A total of 52 (30.5%) patients required renal replacement therapy. Out of these 35 underwent hemodialysis, 12 underwent peritoneal dialysis and 5 required CVVHD.

PloS one, 2012

The high mortality rates that follow the onset of acute kidney injury (AKI) are well recognised. However, the mode of death in patients with AKI remains relatively under-studied, particularly in general hospitalised populations who represent the majority of those affected. We sought to describe the primary cause of death in a large group of prospectively identified patients with AKI. All patients sustaining AKI at our centre between 1(st) October 2010 and 31(st) October 2011 were identified by real-time, hospital-wide, electronic AKI reporting based on the Acute Kidney Injury Network (AKIN) diagnostic criteria. Using this system we are able to generate a prospective database of all AKI cases that includes demographic, outcome and hospital coding data. For those patients that died during hospital admission, cause of death was derived from the Medical Certificate of Cause of Death. During the study period there were 3,930 patients who sustained AKI; 62.0% had AKI stage 1, 20.6% had st...

Primary Care: Clinics in Office Practice, 2008

SBMU publishing, 2018

Introduction: Elimination of preventable deaths due to acute kidney injury (AKI) in low-income countries by 2025 is an important healthcare goal at the international level. The present study was designed with the aim of evaluating the prevalence and outcome of AKI in patients presenting to emergency department. Methods: The present cross-sectional, retrospective study was performed on patients that presented to the emergency departments of 3 major teaching hospitals, Tehran, Iran, between 2005 and 2015 and were diagnosed with AKI. Patient selection was done using consecutive sampling and required data for this study was extracted by referring to the medical profiles of the patients and filling out a checklist designed for the study. Results: 770 AKI patients with the mean age of 62.72 ± 19.79 (1 – 99) years were evaluation (59.1% male). 690 (89.61%) cases of AKI causes were pre-renal or renal. Among the pre-renal causes, 74 (73.3%) cases were due to different types of shock (p < 0.001). The most common etiologic causes of AKI in pre-renal group were hypotension (57.3%) and renal vascular in-sufficiency (31.6%). In addition, regarding the renal types, rhabdomyolysis (35.0%), medication (17.5%) and chemotherapy (15.3%) and in post-renal types, kidney stone (34.5%) were the most common etiologic causes. 327 (42.5%) patients needed dialysis and 169 (21.9%) patients died. Sex (p = 0.001), age over 60 years (p = 0.001), blood urea nitrogen level (p < 0.001), hyperkalemia (p < 0.001), metabolic acidosis (p < 0.001), cause of failure (p = 0.001), and type of failure (p = 0.009) were independent risk factors of mortality. Conclusion: The total prevalence of AKI in emergency department was 315 for each 1000000 population and preventable mortality rate due to AKI was estimated to be 28.2 cases in each 1000000 population. The most important preventable AKI causes in the pre-renal group included shock, sepsis, and dehydration; in the renal group they included rhabdomyolysis and intoxication; and stones in the post-renal group.

Lancet (London, England), 2017