![]() | Only 14 pages are availabe for public view |
Abstract Acute kidney injury (AKI) is recognized as a very common problem in critically ill patients, and is strongly associated with increased resource utilization, and higher short-term and long-term mortality. Globally, AKI affects over 13 million people per year and results in 1.7 million deaths. Four in five cases of AKI occur in the developing world. AKI is diagnosed in up to 20% of hospitalized subjects, and in 30–60% of critically ill subjects. AKI is the most frequent cause of organ dysfunction in intensive care units (ICUs) and the occurrence of even mild AKI is associated with a 50% higher risk of death. Several risk factors for occurrence of AKI in critical care setting has been identified, these factors are more nuanced rather than being single risk. Elderly patients appear to experience AKI more often than younger patients due to physiological ageing of the kidneys, presence of co-morbidities and impaired renal capacity for recovery. The aim of our study was to evaluate patterns, causes and outcomes of acute kidney injury in critically ill patients in Luxor international hospital. This study was conducted on conducted on 92 egyptian patients presented with acute kidney injury who were admitted in Intensive Care Units of Luxor international hospital. All patients were submitted to full history, clinical examination, and laboratory testing which included serum creatinine (at admission, at peak, and at discharge), sodium,potassium, urea, calcium, phosphorus and uric acid, complete blood count,pelviabdominal ultrasound, and daily measurement of urine output (UOP). AKI patients were classified according to Acute Kidney Injury Network staging. The current study found that AKI is associated with high mortality rate in our ICU setting. We found that risk factors of AKI were DM (29.3%), HTN (9.8%), CKD(8.5%) and cardiovascular diseases (7.3%). According to the AKIN staging system, our study demonstrated that the number of stages I, II, and III in the studied patients were 21 (25.6%), 15 (18.3%), and 46 (56.1%), respectively. Our study results showed highly statistical significant association (p-value < 0.001) between prognosis and severity of renal injury according to AKIN staging. The results of current study showed that prerenal causes were common than renal, and postrenal causes. The number of patients with prerenal, renal, and postrenal causes was 46 (56.1%), 29 (35.4%) and 7 (8.5%), respectively. The results of current study showed highly statistical significant association (p-value < 0.001) between prognosis and types of AKI, renal AKI has more bad prognosis than pre and post renal AKI. As regard prognosis, there were 32 patients (39%) with recovery and 50 patients (61%) with no recovery. As regard outcome, there were 31 patients (37.8%) died and 51 patients (62.2%) still alive. |