Investigation of acute kidney injury and related factors in hospital patients; single center experience

Yıl 2022, Cilt: 2 Sayı: 2, 36 - 41, 29.04.2022

Mehmet Biricik , Feyzi Bostan

https://doi.org/10.56016/dahudermj.1074611

Cited By: 1

Öz

Objectives: Acute Kidney Injury (AKI) is a very common clinical problem. This picture is seen in 5-7% of hospitalized patients and in 25-30% of patients hospitalized in intensive care units. The aim of this study was to determine the incidence, etiology, clinical features, prognosis and complications in adult patients hospitalized with of AKI.
Methods: This study was organized as an observation study in which the files of the patients admitted to internal medicine and nephrology clinics between September 2012 and September 2017 were examined. All patients admitted to the internal medicine and nephrology clinics with the diagnosis of AKI were included in the study. But those under the age of 18, patients with chronic kidney damage, ex-patients after hospitalization, patients who were sent to the intensive care unit after hospitalization, patients who voluntarily refused treatment or left the service and who were hospitalized for more than 48 hours, but those who did not have biochemical analysis during their stay were excluded. RIFLE creatinine criteria were used for AKI identification.
Results: The study included 354 patients. 177 (50%) patients were male and 177 (50%) patients were female. The incidence of prerenal AKI in the internal medicine and nephrology clinics was 53.39%, renal AKI was 36.44% and postrenal AKI was 10.17%. When the causes of AKI were examined, 33.9% hypovolemia, 15.5% UTI and 13.5% gastroenteritis were detected. The dialysis rate was 23.7%.
Conclusion: Inconclusion, although the incidence of AKI is acceptable in our hospital. It is found to be compatible with the literature and it is possible to catch the early stage of injury by decreasing the frequency especially with better management of elderly patients and more closely monitoring renal functions in this group of patients.

Anahtar Kelimeler

acute renal failure, hemodialysis, kidney, acute renal failure, hemodialysis, kidney

Kaynakça

• Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet 365; 2005:417-430.
• Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal fail- ure—definition, outcome measures, animal models, fluid thera- py and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8:204-12.
• Kellum JA, Bellomo R, Ronco C. Classification of acute kid- ney injury using RIFLE: What‘s the purpose? Crit Care Med 2007; 35:1983-4.
• Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jef- ferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007; 71:1028-35.
• Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D, Kellum JA. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill ap- tients: A cohort analysis. Crit Care 2006; 10:R73
• Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, War- nock DG, Levin A. Acute Kidney Injury Network Acute Kidney Injury Network.: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11:R31
• Lopes JA, Fernandes P, Jorge S, Gonçalves S, Alvarez A, Cos- ta e Silva Z, França C, Prata MM. Acute kidney injury in in- tensive care unit patients: a comparison between the RIFLE and the Acute Kidney Injury Network classifications. Crit Care 2008; 12(4): R110
• Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, Paganini EP, Chertow GM. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kid- ney Int. 2004; 66:1613-21
• Lamiere N, Biesen WV, Vanholder R: Acute renal failure. Lan- cet 2005; 365:417- 30.
• Gill N, Nally Jr JV, Fatica RA. Renal failure secondary to acute tubuler necrosis: epidemiology, diagnosis, and manage- ment. Chest 2005; 128:2847-63.
• Ympa YP, Sakr Y, Reinhart K, Vincent JL. Has mortality from acute renal failure decreased? Asystematic review of the literature. Am J Med 2005; 118:827-32.
• Liu KD, Chertow GM. Acute Renal Failure In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds). Harrıson’s Principles of Internal Medicine.. USA. Mc Graw Hill Medical 2008:1752-61.
• Jafferson JA, Thurman JM, Schrier RW. Pathophysiology and etiology of acute kidney injury. In: Floege J, Jonhson RJ, Feehally J (eds). Comprehensive Clinical Nephrology.. St. Louis, Misouri, USA. Elsevier 2010: 797-813
• Singri N, Ahja SN, Levin ML. Acute renal failure. JAMA 2003; 289:747-51.
• Selcuk NY, Odabaş AR, Cetinkaya R ,Tonbul HZ, San A. Frequency and outcome of patients with acute renal failure have more causes than one in etiology. Ren Fail 2000; 22:459-64.
• Macedo E, Bouchard J, Mehta RL. Prevention and nondialyt- ic management of acute kidney injury. In: Floege J, Jonhson RJ, Feehally J (eds). Comprehensive Clinical Nephrology.. St. Louis, Misouri, USA. Elsevier 2010: 830-43.
• El-Reshaid K, Kapoor M, Johny KV, Sugathan TN. Acute re- nal failure in Kuwait- aprospective study. J Trop Med Hyg. 1993; 96:323-9.
• Kohli HS, Bhaskaran MC, Muthukumar T, Thennarasu K, Sud K, Jha V, Gupta KL,Sakhuja V. Treatment-related acute renal failure in the elderly: a hospital-based prospective study. Nephrol Dial Transplant. 2000 ;15:212-7.
• Rabbani MA, Habib HB, Siddiqui BK, Tahir MH, Ahmad B, Murtaza G, Maria Q,Ahmad A. Etiology of acute renal failure in a tertiary center. Saudi J Kidney DisTranspl. 2008 ;19:1009-14.
• Wang Y, Cui Z, Fan M. Retrospective analysis on Chinese patients diagnosed with acute renal failure hospitalized during the last decade (1994-2003). Am J Nephrol. 2005 ;25:514-9.
• Biesenbach G, Janko O, Schmekal B. Etiology and progno- sis of “internal medicine” acute renal failure in 1981-1990 and 1991-2000-an analysis of 510 cases in a single centerWien Med Wochenschr. 2003; 15
• Selçuk NY, Odabas AR, Cetinkaya R, Tonbul HZ, San A. Frequency and outcome of patients with acute renal failure have more causes than one in etiology. Ren Fail. 2000; 22:459-64.
• Zhang L, Wang M, Wang H. Acute renal failure in chronic kidney disease-clinical and pathological analysis of 104 cases. Clin Nephrol. 2005; 63:346-50.
• Mahajan S, Tiwari S, Bhowmik D, Agarwal SK, Tiwari SC, Dash SC. Factors affecting the outcome of acute renal failure among the elderly population in India: a hospital based study. Int Urol Nephrol. 2006; 38:391-6.
• Uyanık A. Akut Böbrek Yetmezliğinde Prognoza Etki Eden Faktörlerin Araştırılması. Uzmanlık Tezi. Atatürk Üniversitesi Tıp Fakültesi, iç Hastalıkları Anabilim Dalı, Nefroloji Bilim Dalı, 2010.