Epidemiology of Acute Kidney Injury in Latin America

Lombardi, Raúl; Yu, Liang; Younes-Ibrahim, Maurício; Schor, Nestor; Burdmann, Emmanuel A.

doi:10.1016/j.semnephrol.2008.04.001

Cited by 76 publications

(69 citation statements)

References 59 publications

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“…Studies from developing countries have shown that AKI incidence varies (14,(19)(20)(21)(22)(23) and that AKI is often community acquired and preventable (i.e., due to gastroenteritis and infections) (23)(24)(25)(26)(27). However, a formal comparison between developed and emerging countries is lacking (14,28).…”

Section: Introductionmentioning

confidence: 99%

A Prospective International Multicenter Study of AKI in the Intensive Care Unit

Bouchard

Acharya

Cerdá

et al. 2015

Clinical Journal of the American Society of Nephrology

223

166

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Background and objectives AKI is frequent and is associated with poor outcomes. There is limited information on the epidemiology of AKI worldwide. This study compared patients with AKI in emerging and developed countries to determine the association of clinical factors and processes of care with outcomes.Design, setting, participants, & measurements This prospective observational study was conducted among intensive care unit patients from nine centers in developed countries and five centers in emerging countries. AKI was defined as an increase in creatinine of $0.3 mg/dl within 48 hours.Results Between 2008 and 2012, 6647 patients were screened, of whom 1275 (19.2%) developed AKI. A total of 745 (58% of those with AKI) agreed to participate and had complete data. Patients in developed countries had more sepsis (52.1% versus 38.0%) and higher Acute Physiology and Chronic Health Evaluation (APACHE) scores (mean6SD, 61.1627.5 versus 51.1625.2); those from emerging countries had more CKD (54.3% versus 38.3%), GN (6.3% versus 0.9%), and interstitial nephritis (7.0% versus 0.6%) (all P,0.05). Patients from developed countries were less often treated with dialysis (15.5% versus 30.2%; P,0.001) and started dialysis later after AKI diagnosis (2.0 [interquartile range, 0.75-5.0] days versus 0 [interquartile range, 0-5.0] days; P=0.02). Hospital mortality was 22.0%, and 13.3% of survivors were dialysis dependent at discharge. Independent risk factors associated with hospital mortality included older age, residence in an emerging country, use of vasopressors (emerging countries only), dialysis and mechanical ventilation, and higher APACHE score and cumulative fluid balance (developed countries only). A lower probability of renal recovery was associated with residence in an emerging country, higher APACHE score (emerging countries only) and dialysis, while mechanical ventilation was associated with renal recovery (developed countries only).Conclusions This study contrasts the clinical features and management of AKI and demonstrates worse outcomes in emerging than in developed countries. Differences in variations in care may explain these findings and should be considered in future trials.

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Section: Introductionmentioning

confidence: 99%

A Prospective International Multicenter Study of AKI in the Intensive Care Unit

Bouchard

Acharya

Cerdá

et al. 2015

Clinical Journal of the American Society of Nephrology

223

166

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“…In Asia diarrheal disease, malaria, leptospirosis and snake bites constitute over 60% of AKI 8,10,11 . There is little epidemiological data from Latin America, however communicable diseases remain an important cause 12 . ICU-specific data from developed countries indicates an incidence of hospital-acquired AKI of between 5% and 20% of ICU admissions, corresponding to 66-80 per million population per year 13,14,15 .…”

Section: Incidence and Aetiologiesmentioning

confidence: 99%

Acute kidney injury – improving outcomes with early risk assessment and intervention

Rathnamalala

Rajapakse

2014

J of Cey Coll of Phy

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“…A meta-analysis published in June 2013, showed high heterogeneity of AKI incidence with imbalances between the northern and southern hemispheres and between socioeconomic statuses of countries [4]. A comprehensive study conducted by the SLANH, determined that AKI has a bimodal pattern; in urban areas, the behavior is similar to high-income countries; while in the rural area observed a different pattern aimed young, healthy patients influenced by environmental and socioeconomic cultural conditions [5,6].…”

Section: Introductionmentioning

confidence: 99%