Background
Objective
Methods
I Cohort study
Data collection
Definitions of AKI
Comparison of AKI definitions
Statistical analyses
II Review
Results
I Cohort study
Patients
Characteristic of patients (N = 1376) | |
---|---|
Age (years; mean (sd)) | 60 (16) |
Male sex (N (%)) | 864 (62.8) |
Body Mass Index (kg/m2, mean(sd)) | 26 (5.2) |
APACHE IV (mean(sd)) | 52 (25) |
Admission type | |
• Medical (N (%)) | 461 (33.5) |
• Surgical (N (%)) | 914 (66.4) |
◦ scheduled (N (%)) | 727 (52.8) |
◦ emergency (N (%)) | 187 (13.6) |
Co morbidity | |
• diabetes mellitus (N (%)) | 221 (16.1) |
• chronic kidney disease (N (%)) | 58 (4.2) |
• chronic dialysis (N (%)) | 24 (1.7) |
ICU LoS (days; median [IQR]) | 2 [2.0–3.0] |
ICU mortality (N (%)) | 77 (5.6) |
Hospital mortality (N (%)) | 129 (9.4) |
Serum creatinine at admission (μmol/l; median [IQR]) (N = 1369) | 73 [58–93] |
Acute kidney injury in first 7 days of admission | |
• RIFLE (N (%)) | 210 (15.2) |
◦ With UO criteria (N (%)) • AKIN (N (%)) | 475 (34.5) 294 (21.4) |
◦ With UO criteria (N (%)) | 524 (38.1) |
• KDIGO (N (%)) | 281 (20.4) |
◦ With UO criteria (N (%)) | 517 (37.6) |
• Urine output RIFLE (N (%)) | 265 (19.3) |
• Urine output AKIN (N (%)) | 230 (16.7) |
• Urine output KDIGO (N (%)) | 236 (17.2) |
Renal replacement therapy (N (%)) | 62 (4.5) |
Total prevalence of AKI varies with the definition
Definition | RIFLE (N = 326) | AKIN (N = 310) | KDIGO (N = 308) | ||||||
---|---|---|---|---|---|---|---|---|---|
UO only (N = 265) | UO and SCr (N = 61) |
p-value | UO only (N = 230) | UO and SCr (N = 80) |
p-value | UO only (N = 236) | UO and SCr (N = 72) |
p-value | |
Characteristics of patients | |||||||||
Age (years; mean (sd)) | 62 (15) | 63 (15) | 0.753 | 62 (15) | 62 (15) | 0.978 | 62 (15) | 63 (14) | 0.478 |
Male sex (N (%)) | 173 (54) | 34 (10) | 0.185 | 149 (48) | 45 (15) | 0.182 | 153 (50) | 41 (13) | 0.265 |
Body Mass Index (kg/m2; mean (sd)) | 27 (5) | 26 (6) | 0.184 | 27 (5.2) | 26 (5.7) | 0.051 | 27 (5.3) | 26 (5.8) | 0.118 |
APACHE IV score (mean (sd)) | 54 (25) | 75 (22) | 0.000 | 52 (23) | 72 (26) | 0.000 | 52 (23) | 74 (26) | 0.000 |
Admission type | |||||||||
• medical (N (%)) | 105 (32) | 22 (6.7) | 0.009 | 88 (28) | 31 (10) | 0.052 | 95 (31) | 22 (7.1) | 0.006 |
• surgical | |||||||||
◦ scheduled (N (%)) | 124 (38) | 21 (6.4) | 112 (36) | 30 (9.7) | 112 (36) | 30 (9.7) | |||
◦ emergency (N (%)) | 36 (11) | 18 (5.5) | 30 (9.7) | 19 (6.1) | 29 (9.4) | 20 (6.5) | |||
Co morbidity | |||||||||
• diabetes mellitus (N (%)) | 47 (14) | 11 (3.4) | 1 | 40 (13) | 12 (3.9) | 0.729 | 41 (13) | 11 (3.6) | 0.857 |
• chronic kidney disease (N (%)) | 3 (0.9) | 2 (0.6) | 0.236 | 2 (0.6) | 3 (0.9) | 0.110 | 2 (0.6) | 3 | 0.085 |
• chronic dialysis (N (%)) | 0 (0) | 0 (0) | na | 0 (0) | 0 (0) | na | 0 (0) | (0.97) 0 (0) | na |
ICU Length of stay (days; median [IQR]) | 3 [2–6] | 6 [3–11] | 0.000 | 3 [2–5] | 6 [3–11] | 0.000 | 3 [2–6] | 5 [3–9.8] | 0.000 |
ICU mortality (N (%)) | 13 (4.0) | 6 (1.8) | 0.139 | 8 (2.6) | 11 (3.5) | 0.002 | 10 (3.2) | 9 (2.9) | 0.021 |
Hospital mortality (N (%)) | 24 (7.4) | 13 (4.0) | 0.012 | 17 (5.5) | 19 (6.1) | 0.000 | 19 (6.2) | 17 (5.5) | 0.001 |
Characteristic of patients | Group 1 No AKI
N = 1078 | Group 2 RIFLE, AKIN & KDIGO AKI
N = 212 | Group 3 AKIN & KDIGO AKI
N = 70 | Group 4 AKIN AKI
N = 14 |
p value |
---|---|---|---|---|---|
Age (years; mean (sd)) | 63 (19) | 67 (20) | 68 (15) | 54 (28) | <0.05 (*) |
Male sex (N (%)) | 681 (63.1) | 122 (57.5) | 52 (74.3) | 8 (57.1) | 0.078 |
Body Mass Index (kg/m2; mean (sd)) | 25.8 (5.6) | 26.2 (5.6) | 26 (6.2) | 25.6 (4.7) | 0.013 (****) |
APACHE IV score (mean (sd)) | 43 (25) | 76 (30) | 56 (26.5) | 51.5 (36.5) | 0.001 (***) |
Admission type | |||||
• Medical (N (%)) | 308 (28.6) | 114 (53.8) | 26 (37.1) | 12 (85.7) | 0.001 |
• Surgical | |||||
◦ Scheduled (N (%)) | 640 (59.4) | 53 (25) | 32 (45.7) | 2 (14.3) | |
◦ Emergency (N (%)) | 129 (12) | 45 (21.2) | 12 (17.1) | 0 (0) | |
Co morbidity | |||||
• diabetes mellitus (N (%)) | 149 (13.8) | 62 (29.2) | 9 (12.9) | 1 (7.1) | 0.001 |
• chronic kidney disease (N (%)) | 5 (0.5) | 48 (22.6) | 4 (5.7) | 0 (0) | 0.001 |
• chronic dialysis (N (%)) | 0 (0) | 23 (10.8) | 1 (1.4) | 0 (0) | 0.001 |
ICU Length of stay (days; median [IQR]) | 2 (2–3) | 4 (2–8) | 2 (2–4) | 13 (4–13) | 0.001 (****) |
ICU mortality (N (%)) | 37 (3.4) | 30 (14.1) | 7 (10) | 3 (21.4) | 0.001 |
Hospital mortality (N (%)) | 64 (5.9) | 51 (24.1) | 11 (15.7) | 3 (21.4) | 0.001 |