Clinical outcomes of acute kidney injury patients treated in a single-center, sub-urban satellite hospital
Acute kidney injury (AKI) is a common diagnosis among critically ill patients. Although the etiology of AKI will determine the appropriate initial management, the definitive management of established AKI is still debatable. This is a retrospective, observational, single-center analysis of a cohor...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Saudi Center for Organ Transplantation
2015
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/43845/ http://irep.iium.edu.my/43845/ http://irep.iium.edu.my/43845/1/SaudiJKidneyDisTranspl264725-7849264_214812.pdf |
| Summary: | Acute kidney injury (AKI) is a common diagnosis among critically ill patients.
Although the etiology of AKI will determine the appropriate initial management, the definitive
management of established AKI is still debatable. This is a retrospective, observational, single-center
analysis of a cohort of patients referred to the nephrology unit for AKI from 1st August 2010 to 31st January 2011. Those patients with indications for dialysis were treated with continuous renal
replacement therapy, intermittent hemodialysis or stiff-catheter peritoneal dialysis as determined by
their hemodynamic status and the technical availability of the method. The 30-day mortality rate, renal
outcomes and independent prognostic factors were analyzed statistically. Seventy-five patients were
reviewed. The mean age was 52.9 ± 14.5 years. Two-thirds were males and 75% were Malays. 53.3%
were referred from intensive wards. Pre-renal AKI and intra-renal AKI were diagnosed in 21.3% and
73.3% patients, respectively. Sepsis was the most common cause (n = 59). The pathogens were
successfully cultured in 42.3% of the cases. The median urea and creatinine were 30.4 [interquartile
range (IQR) 20.3] mmol/L and 474 (IQR 398.0) µmol/L, respectively. Seventy-six percent had
metabolic acidosis. Oliguria was only noted in 38.7% of the patients. Sixty percent (n = 45) of the
referrals were treated with conventional, intermittent hemodialysis and 22.7% (n = 17) with continuous
veno-venous hemofiltration. The 30-day mortality rate was 28%, and was higher in intensive wards
(37.5% versus 17.1%). Thirty-one percent (n = 20) had complete recovery, 17 (26.6%) had partial
recovery without dialysis and seven (10.9%) became dialysis dependent. The 30-day mortality rate
was 28%. Referral from intensive wards was the only significant poor prognostic factor in our patients
and not the dialysis modalities. |
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