Non-recovery of renal function is a strong independent risk factor associated with mortality in AKI patients

Abstract

Introduction: Acute kidney injury (AKI) is a recurrent complication in the intensive care unit (ICU) and is associated with negative outcomes. Objective: To investigate factors associated with mortality in critically ill AKI patients in a South Brazilian ICU. Methods: The study was observational retrospective involving AKI patients admitted to the ICU between January 2011 and December 2016 of at least 18 years old upon admission and who remained in the ICU at least 48 hours. Comparisons between selected characteristics of survivor and non-survivor groups were done using univariate analysis; multivariate logistic regression was applied to determine factors associated with patient mortality. Results: Of 838 eligible patients, 613 participated in the study. Men represented the majority (61.2%) of the patients, the median age was 53 years, and the global mortality rate was 39.6% (n= 243). Non-recovery of renal function after AKI (OR= 92.7 [38.43 - 223.62]; p <0.001), major surgery-associated AKI diagnosis (OR= 16.22 [3.49 - 75.38]; p <0.001), and the use of vasoactive drugs during the ICU stay (OR = 11.49 [2.46 - 53.70]; p <0.002) were the main factors independently associated with patient mortality. Conclusion: The mortality rate observed in this study was similar to that verified in other centers. Non-recovery of renal function was the variable most strongly associated with patient mortality, suggesting that the prevention of factors that aggravate or maintain the AKI episode should be actively identified and mitigated, possibly constituting an important strategy to reduce mortality in AKI patients.

Predictive capacity of prognostic scores for kidney injury, dialysis, and death in intensive care units

“…Different aspects influence incidence rates, which can still be affected by geographic aspects. While an international multicenter study showed a global AKI prevalence rate of 44.6% in patients in critical care units, specifically in South America a reduction was identified, 12.7% (7) , but in another study this variation reached 20% to 40% of involvement (8) . However, despite advances in diagnosis and therapies, mortality has changed little in recent years, affecting 40% to 80% of patients admitted to ICUs, which emphasizes the need to implement tools to the earlier identification of acute kidney injury (9) .…”

Benefits of D-005, a lipid extract from Acrocomia crispa fruits, in the prevention of acute kidney njury induced by nephrotoxicity in rats

“…Acute kidney injury (AKI) is a clinical syndrome of varied etiology characterized by a sudden decrease in kidney function, accumulation of waste metabolites, water-mineral imbalance, and systemic symptoms. It is a common problem in intensive care medicine since a moderate AKI increases the risk of death by approximately five times 1 , 2 .…”