Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Córdova-Sánchez, Bertha M; Herrera‐Gómez, Ángel; Ñamendys‐Silva, Silvio A.

doi:10.1155/2016/6805169

Cited by 21 publications

(22 citation statements)

References 34 publications

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“…Moreover, these are also the chronic conditions that frequently increase morbidity and mortality for AKI in critically ill patients who are septic, 11,16,25 with fluid overload, 2,9,26 making use of nephrotoxic drugs 16 or who have undergone major surgeries. 7,8 Other chronic pathological conditions that are also noted as risk factors for AKI incidence and mortality in critically ill patients include cardiovascular, 9,17,27-30 respiratory, 10,31 cerebrovascular, 16 cirrhosis, 32,33 cancer 15,25 , and human immunodeficiency virus infection. 10,34 Several studies have shown baseline renal function as one of the most important risk factors for AKI.…”

Section: Discussionmentioning

confidence: 99%

An epidemiologic overview of acute kidney injury in intensive care units

Santos

Carvalho

Peres

et al. 2019

Rev. Assoc. Med. Bras.

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SUMMARY INTRODUCTION Acute kidney injury (AKI) is a frequent event among critically ill patients hospitalized in intensive care units (ICU) and represents a global public health problem, being imperative an interdisciplinary approach. OBJECTIV To investigate, through literature review, the AKI epidemiology in ICUs. METHODS: Online research in Medline, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences databases, with analysis of the most relevant 47 studies published between 2010 and 2017. RESULTS Data of the 67,033 patients from more than 300 ICUs from different regions of the world were analyzed. The overall incidence of AKI ranged from 2.5% to 92.2%, and the mortality from 5% to 80%. The length of ICU stay ranged from five to twenty-one days, and the need for renal replacement therapy from 0.8% to 59.2%. AKI patients had substantially higher mortality rates and longer hospital stays than patients without AKI. CONCLUSION AKI incidence presented high variability among the studies. One of the reasons for that were the different criteria used to define the cases. Availability of local resources, renal replacement therapy needs, serum creatinine at ICU admission, volume overload, and sepsis, among others, influence mortality rates in AKI patients.

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Section: Discussionmentioning

confidence: 99%

An epidemiologic overview of acute kidney injury in intensive care units

Santos

Carvalho

Peres

et al. 2019

Rev. Assoc. Med. Bras.

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“…AKI was defined according to the KDIGO definition. 7 As per 2011 Renal Association guidelines, 9 and recent articles, [22][23][24][25] baseline creatinine was defined as the lowest creatinine level recorded within 3 months. If a 3-month creatinine was not available, then AKI was not diagnosed, assuming other criteria were not met.…”

Section: Resultsmentioning

confidence: 99%

The impact of the NHS electronic-alert system on the recognition and management of acute kidney injury in acute medicine

2019

Clinical Medicine

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To address inconsistencies in the recognition and management of acute kidney injury (AKI), an electronic-alert (e-alert) system was implemented by NHS England in 2015. This study aimed to describe its impact within acute medicine in the West Midlands. All admissions to included acute medical units were screened for AKI in two phases, before and after the e-alert was introduced. Data describing recognition and management of patients with AKI were collected. In the 10 units that participated in both phases, recognition of AKI by clinicians signifi cantly improved from 67.9% in 2015 to 76.1% in 2016 (p=0.04). Further analysis of the data found that the presence of an e-alert had a limited effect on recognition and management, suggesting it was not the primary cause of the improvements. Multiple avenues of research have been recommended to clarify the impact of the e-alert system and to improve defi ciencies in management that were identifi ed in the data.

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“…From their large database, Kellum et al reported that 59% of ICU patients with acute kidney injury (AKI) met the KDIGO urine output criteria [8]. In a smaller cohort, Md Ralib et al reported that 61% of patients with AKI met urine output criteria (< 0.5 ml/kg/h) [11], and in a study of critically ill cancer patients, 56% met urine output criteria for AKI [18]. The mortality rate was higher in patients with oliguria than in those without.…”

Section: Discussionmentioning

confidence: 99%

The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database

et al. 2020

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Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome. Methods: International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.

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Acute Kidney Injury Classified by Serum Creatinine and Urine Output in Critically Ill Cancer Patients

Cited by 21 publications

References 34 publications

An epidemiologic overview of acute kidney injury in intensive care units

An epidemiologic overview of acute kidney injury in intensive care units

The impact of the NHS electronic-alert system on the recognition and management of acute kidney injury in acute medicine

The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database

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