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. |
