Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome

Objectives: Acute Kidney Injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. To the best of our knowledge, there is no data on the AKI epidemiology based on consensus guideline in our local ICU setting. A pro...

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Main Authors: Md Ralib, Azrina, Mat Nor, Mohd Basri
Format: Proceeding Paper
Language:English
English
Published: Singapore-ANZIC 2015
Subjects:
Online Access:http://irep.iium.edu.my/43431/
http://irep.iium.edu.my/43431/1/SG-ANZICS_2015.pdf
http://irep.iium.edu.my/43431/4/EPI_AKI_SG-ANZICS_v5.pdf
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author Md Ralib, Azrina
Mat Nor, Mohd Basri
author_facet Md Ralib, Azrina
Mat Nor, Mohd Basri
author_sort Md Ralib, Azrina
building IIUM Repository
collection Online Access
description Objectives: Acute Kidney Injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. To the best of our knowledge, there is no data on the AKI epidemiology based on consensus guideline in our local ICU setting. A prospective study in our population utilising the recent AKI consensus guideline is warranted. This will also allow us to investigate the associated risk factors and outcome. Methods: This was a single centre, prospective observational study. All patients more than 18 years being admitted to ICU and stayed for more than 48 hours were included in the study. The study was registered under the Malaysian National Medical Research Register, and approved by the ethics committee. AKI was defined based on either creatinine (AKICr) or urine output criteria (AKIUO) of the Kidney Disease Improving Global Outcome guideline. Results: One hundred forty three patients were recruited, of these, 93 (65%) had AKI. 13% were Stage 1, 16% Stage 2 and 36% Stage 3. 38% were classified as AKICr, and 61% were classified as AKIuo. Risk factors for AKI includes higher APACHE II Scores, medical category admission and vasopresor therapy (Adjusted OR 1.17 (1.08 to 1.27), 2.95 (1.20 to 7.25), and 2.31 (1.00 to 5.32) respectively). 25% percent of patients received dialysis, and 23% died. AKI was an independent risk factor for death (Adjusted HR 2.61 (1.06 to 6.42)). Conclusions: AKI is common in our ICU, with higher risk of death. Risk factors of AKI include higher severity of illness, medical admission category, and vasopressor therapy. Of those with AKI, almost half are with highest severity, which reflects the late presentation of illness on ICU admission in our population. AKI by the urine output is more sensitive compared to creatinine criteria.
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language English
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spelling iium-434312020-05-18T04:01:40Z http://irep.iium.edu.my/43431/ Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome Md Ralib, Azrina Mat Nor, Mohd Basri R Medicine (General) Objectives: Acute Kidney Injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. To the best of our knowledge, there is no data on the AKI epidemiology based on consensus guideline in our local ICU setting. A prospective study in our population utilising the recent AKI consensus guideline is warranted. This will also allow us to investigate the associated risk factors and outcome. Methods: This was a single centre, prospective observational study. All patients more than 18 years being admitted to ICU and stayed for more than 48 hours were included in the study. The study was registered under the Malaysian National Medical Research Register, and approved by the ethics committee. AKI was defined based on either creatinine (AKICr) or urine output criteria (AKIUO) of the Kidney Disease Improving Global Outcome guideline. Results: One hundred forty three patients were recruited, of these, 93 (65%) had AKI. 13% were Stage 1, 16% Stage 2 and 36% Stage 3. 38% were classified as AKICr, and 61% were classified as AKIuo. Risk factors for AKI includes higher APACHE II Scores, medical category admission and vasopresor therapy (Adjusted OR 1.17 (1.08 to 1.27), 2.95 (1.20 to 7.25), and 2.31 (1.00 to 5.32) respectively). 25% percent of patients received dialysis, and 23% died. AKI was an independent risk factor for death (Adjusted HR 2.61 (1.06 to 6.42)). Conclusions: AKI is common in our ICU, with higher risk of death. Risk factors of AKI include higher severity of illness, medical admission category, and vasopressor therapy. Of those with AKI, almost half are with highest severity, which reflects the late presentation of illness on ICU admission in our population. AKI by the urine output is more sensitive compared to creatinine criteria. Singapore-ANZIC 2015-04-24 Proceeding Paper PeerReviewed application/pdf en http://irep.iium.edu.my/43431/1/SG-ANZICS_2015.pdf application/pdf en http://irep.iium.edu.my/43431/4/EPI_AKI_SG-ANZICS_v5.pdf Md Ralib, Azrina and Mat Nor, Mohd Basri (2015) Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome. In: 3rd Singapore-ANZICS Intensive Care Forum 2015 (SG-ANZIC), 24th - 26th April 2015, Singapore. (Unpublished)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Mat Nor, Mohd Basri
Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title_full Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title_fullStr Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title_full_unstemmed Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title_short Acute kidney injury in a Malaysian Intensive Care Unit: incidence, risk factors and outcome
title_sort acute kidney injury in a malaysian intensive care unit: incidence, risk factors and outcome
topic R Medicine (General)
url http://irep.iium.edu.my/43431/
http://irep.iium.edu.my/43431/1/SG-ANZICS_2015.pdf
http://irep.iium.edu.my/43431/4/EPI_AKI_SG-ANZICS_v5.pdf