Epidemiology, clinical characteristics and outcome of acute kidney injury in intensive care units in egyptian patients
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Patients admitted to ICU unit are confronted to various organic, nervous, and metabolic changes that may affect the prognosis and outcome in them. The recognition of Acute Kidney Injury (AKI) by measuring serum creatinine level often occurs hours to days after the initial insult, hence the need for specific marker(s) that can detect renal injury in earlier stages for institution of appropriate therapeutic measures to reverse or prevent worsening of functional or structural kidney abnormalities Aim of study: To determine the incidence, the etiology, clinical characteristics and prognosis of acute kidney injury in patients admitted to various intensive care units at Banha University Hospitals,and to evaluate different therapeutic modalities given to those patients for management of acute kidney injury. Methods: All patients who were admitted to intensive care units (ICUs) at Banha University Hospitals were prospectively studied. Patients who developed ICU-acquired acute renal failure were collected in the period between the first of November 2007 and 31th March 2010. Results: In Our study 749 patients (21.2%) were met AKIN criteria, 26.3% classified as stage 1, 20.2% classified as stage 2, 53.5% classified as stage 3. There was an increase in hospital mortality with increasing AKIN class with patients who were stage lhaving mortality rate of 30.5%, patients who were stage 2 having mortality rate of 50.3%, patients who were stage 3 having mortality rate of 52 % . In Our study 742 patients (21%) were met RIFLE criteria, 24% classified as Risk[R], 28.2% classified as Injury[I], 47.8% classified as Failure[F].There was an increase in hospital mortality with increasing RIFLE class with patients who were class R having mortality rate of 30.9%, patients who were class I having mortality rate of 49.3%, patients who were class F having mortality rate of 62 %. In Our study when comparing corresponding degrees of AKI according to AKIN and RIFLE (stage 1 versus 'risk'; stage 2 versus 'injury'; stage 3 versus' failure') no statistical difference in mortality. Conclusions: RIFLE criteria represent a simple tool for the detection and classification of MO and for correlation with clinical outcomes.The AKIN criteria do not in ‘terially improve the sensitivity, robustness and predictive ability of the definition and classification of AM.