Epidemiology of acute kidney injury in surgical intensive care at University Hospital in Egypt. A prospective observational study

Mohamed, Hossam; Mukhtar, Ahmed; Mostafa, Shereen; Wageh, Sama; Eladawy, Akram; Zaghlol, Ahmed; Hasanin, Ahmed; Hosni, Mostafa; Farrag, Mohamed; Botros, Michel; Farok, Sara; Lotfi, Ahmed

doi:10.1016/j.egja.2013.03.003

Epidemiology of acute kidney injury in surgical intensive care at University Hospital in Egypt. A prospective observational study

Authors

10.1016/j.egja.2013.03.003

Abstract

Introduction
The acute kidney injury (AKI) incidence in ICU patients varies widely from 3% to 30%, with mortality ranging from 36% to 90%, depending on the type of ICU, study population, the period during which the study is conducted, and the criteria used to define AKI.
Objectives
The aim of this study was to assess the incidence of AKI among critical ill patients using RIFEL [risk (R), injury (I), failure (F), loss (L), and end-stage kidney disease (E)] classification and to determine the risk factors and outcome of patients who developed AKI in our surgical ICU.
Methods
We conducted a 6-month prospective observational study in the surgical ICU. Patients were classified daily using the RIFLE criteria. Patients were considered as having new AKI if they did not have AKI on ICU admission and subsequently reached at least class risk during their follow-up. Deterioration of AKI was diagnosed if the patient had increased in RIFLE class compared to the initial classification.
Results
One hundred and twelve patients were studied. AKI occurred in 40 (35.7%) of patients. The most common risk factors for AKI are APACHE II score (acute physiology and chronic health evaluation score, version II.) and sepsis. APACHEII was lower in non-AKI group than AKI group (17.3 ± 7.5 versus 22.4 ± 7.4, = 0.001), and sepsis was more common in AKI patients than non-AKI patients (77.5% versus 49% = 0.004). Patients with AKI had a mortality rate of 67.5% which was more in patients with failure compared with risk patients. APACHEII, AKI, and needs for mechanical ventilation were independent risks for mortality.

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