Recent Pattern of Acute Kidney Injury in Bosnia and Herzegovina

Abstract

Introduction:Acute kidney injury (AKI) is one of the major public health issues with constantly increasing incidence, with epidemiology and outcomes that vary substantially across the world.Aim:Aim of our study was to determine epidemiological characteristics and causes of AKI and to provide a comparison of our findings with data from other low and middle income countries.Methods:This retrospective observational study conducted during an 18-month period included 84 patients. Data were collected from hospital information system and patients’ medical records. All data were analyzed using descriptive statistics.Results:More than two-thirds of patients were older than 56 years. Most cases of AKI (54,76%) were hospital-acquired and predominantly developed in intensive care units (32,14%). Dominant risk factor was underlying chronic kidney disease (48,81%) and chronic heart failure (45,24. In majority of patients (73,81%) were identified multiple factors that may have contributed to AKI: infection (90,48%), prerenal factors (77,38%), nephrotoxic agents (69,05%), and sepsis (28,57%). Multiple organ failure was identified in 94,05% of patients: cardiovascular (64,56%), respiratory (58,23%) and hematological (56,96%) system. Half of all patients were alive at last observation day. Leading cause of death was infection/sepsis (21,43%), followed by cancer (16,67%) and shock (14,28%).Conclusion:Data on AKI show great variation, but general picture of AKI resembles more that from high income countries. The need for dialysis and overall mortality remains high. This highlights the importance of early recognition of AKI, timely referral to nephrologist and need for national guidelines and standardized protocols for AKI.

Caracterización de la lesión renal aguda en un hospital de la República Dominicana

“…En contraste a nuestro estudio, múltiples estudios latinoamericanos, se encontró que los diagnósticos más frecuentes fueron las causadas por las enfermedades cardiacas junto con las enfermedades infecciosas las cuales representaron el 72% de la población en estudio (23,29), en contraste en nuestro estudio las causas infecciosas no representaron una muestra significativa. Posibles explicaciones para esto es la falta de reconocimiento temprano o el infradiagnóstico de sepsis como un factor de riesgo independiente para LRA (30) .…”

Clinical Pattern and Outcome of Patients with Acute Kidney Injury in the Emergency Department of Saint Paul’s Hospital Millennium Medical College

“…An estimated 85% of those affected live in the developing world. AKI is thought to contribute to about 1.7 million deaths every year (8,9). Acute kidney injury (AKI) is a challenging problem in Africa because of the high burden of infectious diseases, the late presentation of patients to healthcare facilities, and the lack of resources to support patients with established AKI (10,11).…”

“…An estimated 85% of those affected live in the developing world. AKI is thought to contribute to about 1.7 million deaths every year (8, 9).…”