PMID- 23949404
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151026
LR  - 20220318
IS  - 1982-4335 (Electronic)
IS  - 0103-507X (Linking)
VI  - 23
IP  - 3
DP  - 2011 Sep
TI  - Acute kidney injury in intensive care unit patients: a prospective study on 
      incidence, risk factors and.
PG  - 321-6
LID - S0103-507X2011000300010 [pii]
AB  - OBJECTIVE: To compare the clinical features and outcomes of patients with and 
      without acute kidney injury in an intensive care unit of a tertiary university 
      hospital and to identify acute kidney injury and mortality risk factors. METHODS: 
      This was a prospective observational study of a cohort including 564 patients 
      followed during their stay in the intensive care unit of Hospital das Clinicas da 
      Faculdade de Medicina de Botucatu (Botucatu, Sao Paulo, Brazil) between May 2008 
      and May 2010. Patients were allocated to two different groups: with (G1) and 
      without (G2) acute kidney injury. RESULTS: The incidence of acute kidney injury 
      was 25.5%. The groups were different with respect to the reason for admission to 
      the intensive care unit (sepsis, G1: 41.6% versus G2: 24.1%; P < 0.0001; 
      neurosurgery, postoperative G1: 13.8% versus G2: 38.1%; P < 0.0001); age (G1: 
      56.8 +/- 15.9 vs. G2: 49.8 +/- 17.8 years; P < 0.0001); Acute Physiological Chronic 
      Health Evaluation (APACHE) II score (G1: 21.9 +/- 6.9 versus G2: 14.1 +/- 4.6; P < 
      0.0001); use of mechanical ventilation (G1: 89.2% vs. G2: 69.1%; P < 0.0001) and 
      use of vasoactive drugs (G1: 78.3% vs. G2: 56.1%; P < 0.0001). Higher rates of 
      diabetes mellitus, congestive heart failure, chronic renal disease and use of 
      non-steroidal anti-inflammatory drugs were more frequent in acute kidney injury 
      patients (28.2% vs. 19.7%, P = 0.03; 23.6 vs. 11.6%, P = 0.0002; 21.5% vs. 11.5%, 
      P < 0.0001 and 23.5% vs. 71.%, P < 0.0001, for G1 versus G2, respectively). 
      Length of hospital stay and mortality were also higher for acute kidney injury 
      patients (G1: 6.6 +/- 2.7 days versus G2: 12.9 +/-5.6 days, P < 0.0001 and G1: 62.5% 
      versus G2: 16.4%, P < 0.0001). Multivariate analysis identified the following as 
      risk factors for acute kidney injury: age above 55 years, APACHE II score above 
      16, baseline creatinine above 1.2 and use of non-steroidal anti-inflammatory 
      drugs (odds ratio (OR) = 1.36, 95% confidence interval (95%CI): 1.22 - 1.85; OR = 
      1.2, 95%CI: 1.11 - 1.33; OR = 5.2, 95%CI: 2.3 - 11.6 and OR = 2.15, 95%CI: 1.1 - 
      4.2, respectively). Acute kidney injury was independently associated with longer 
      hospital stay and increased mortality (OR = 1.18, 95%CI: 1.05 - 1.26 and OR = 
      1.24, 95%CI: 1.09 - 1.99, respectively). Analysis of the survival curve 30 days 
      after admission showed 83.3% mortality for acute kidney injury patients and 45.2% 
      for non-acute kidney injury patients (P < 0.0001). CONCLUSION: The incidence of 
      acute kidney injury was high in this intensive care unit; the independent risk 
      factors associated with acute kidney injury were age > 55 years, APACHE II > 16, 
      baseline serum creatinine > 1.2 and use of non-steroidal anti-inflammatory drugs. 
      Acute kidney injury is an independent risk factor for longer intensive care unit 
      stay and mortality.
FAU - Ponce, Daniela
AU  - Ponce D
FAU - Zorzenon, Caroline de Pietro Franco
AU  - Zorzenon Cde P
FAU - Santos, Nara Yamane Dos
AU  - Santos NY
FAU - Teixeira, Ubirajara Aparecido
AU  - Teixeira UA
FAU - Balbi, Andre Luis
AU  - Balbi AL
LA  - eng
LA  - por
PT  - Journal Article
TT  - Injuria renal aguda em unidade de terapia intensiva: estudo prospectivo sobre a 
      incidencia, fatores de risco e mortalidade.
PL  - Brazil
TA  - Rev Bras Ter Intensiva
JT  - Revista Brasileira de terapia intensiva
JID - 9506692
EDAT- 2011/09/01 00:00
MHDA- 2011/09/01 00:01
CRDT- 2013/08/17 06:00
PHST- 2011/05/03 00:00 [received]
PHST- 2011/08/11 00:00 [accepted]
PHST- 2013/08/17 06:00 [entrez]
PHST- 2011/09/01 00:00 [pubmed]
PHST- 2011/09/01 00:01 [medline]
AID - S0103-507X2011000300010 [pii]
PST - ppublish
SO  - Rev Bras Ter Intensiva. 2011 Sep;23(3):321-6.