AL Okaly, A., EL Sayed, I., Salah, A., EL Maghawry, M. (2020). Incidence, Clinical Characteristics and Outcome of Acute Kidney Injury among Critically Ill patients in Zagazig University Hospitals. The Egyptian Journal of Hospital Medicine, 80(3), 1019-1026. doi: 10.21608/ejhm.2020.107565
Amir Mohamed AL Okaly; Islam Ali EL Sayed; Ahmed Mohamed Salah; Mohamed Ahmed EL Maghawry. "Incidence, Clinical Characteristics and Outcome of Acute Kidney Injury among Critically Ill patients in Zagazig University Hospitals". The Egyptian Journal of Hospital Medicine, 80, 3, 2020, 1019-1026. doi: 10.21608/ejhm.2020.107565
AL Okaly, A., EL Sayed, I., Salah, A., EL Maghawry, M. (2020). 'Incidence, Clinical Characteristics and Outcome of Acute Kidney Injury among Critically Ill patients in Zagazig University Hospitals', The Egyptian Journal of Hospital Medicine, 80(3), pp. 1019-1026. doi: 10.21608/ejhm.2020.107565
AL Okaly, A., EL Sayed, I., Salah, A., EL Maghawry, M. Incidence, Clinical Characteristics and Outcome of Acute Kidney Injury among Critically Ill patients in Zagazig University Hospitals. The Egyptian Journal of Hospital Medicine, 2020; 80(3): 1019-1026. doi: 10.21608/ejhm.2020.107565
Incidence, Clinical Characteristics and Outcome of Acute Kidney Injury among Critically Ill patients in Zagazig University Hospitals
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: There is marked variety in Acute Kidney Injury (AKI) incidence and clinical characteristics as regards independent developmental risk factors and independent risk factors that could affect the outcome especially in critical care setting. Objectives: The aim of the work was to identify incidence and the clinical features of AKI in critical care situation and its impression on outcomes. Patients and Methods: A prospective cohort study in which patients were screened for AKI during the period from October 2018 to September 2019 using the AKIN criteria. Results: Incidence of AKI in critical care setting was 20.3% (63/310). The most independent risk factors for the development of AKI based on multivariate Logistic analysis were sepsis (p value: 0.000, estimated odds ratio: 4.492 and confidence intervals between 2.037 and 9.906) and chronic kidney disease (CKD) (p<0.001, estimated odds ratio: 8,982 and confidence intervals between 3,852 and 20,945). The most independent risk factor for poor AKI outcome was the need for renal replacement therapy (RRT) based on a multivariate logistic analysis (p<0.001, estimated odds Ratio: 3.649 and confidence interval between 1.145 and 4.050). Late nephrologist consultation comes in second place (p=0.002, estimated odds ratio: 4.902 and confidence interval between.463 and 9.316). Mortality in AKI group was 31% (3 patients in stage 2 and 17 patients in stage 3) compared to 42/247 (17%) in patients without AKI. Conclusion: The incidence of AKI in Zagazig University Internal Medicine ICU was 20.3 %. Sepsis was the most independent risk factor for the occurrence of AKI in ICU. The most independent risk factors for poor outcome following AKI development were the need for RRT, Late nephrologist consultation, longer duration of AKI and a high APACHE score.
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