Abstract: FR-PO110
The Incidence, Aetiology, and Short-Term Outcomes of AKI in Adults
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Abdalla, Alaeldin, Galway University Hospitals, Galway, Galway, Ireland
- Ahmed, Adeel Rafi, University College Cork, Cork, Cork, Ireland
- Satti, Muniza, University of Galway, Galway, Galway, Ireland
- Lappin, David, Galway University Hospitals, Galway, Galway, Ireland
Background
Acute Kidney Injury (AKI) is a common clinical syndrome in hospitalized patients associated with an increased risk of poor prognosis and mortality. We aimed to identify the incidence, aetiology, and short-term outcomes of adults with AKI on presentation to the hospital.
Methods
Data were prospectively collected over a two-month period. The patients were followed till the time of discharge from the hospital. Patients admitted over two months were investigated, and those with AKI as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria) were identified at the time of admission. Patients with known End Stage Renal Disease (ESRD) on dialysis, renal transplant, Paediatric, and Gynaecology admissions were excluded. Data was collected from the admission records in the emergency department, medical notes, laboratory system and discharge summaries.
Results
There were a total of 2847 patients admitted over the study period, and 2397 were reviewed. The incidence of AKI was 5.92% (n=142). In the AKI population, 54.22% were males and 45.77% were females. The mean±standard deviation(SD) age was 74.6±14.7 years. Chronic kidney disease was present in 53.52%.
The mean±SD creatinine at baseline (pre-admission) was 106±47.1umol/L(1.2±0.53mg/dL), at presentation 190±91.1umol/L (2.15±1.44mg/dL), and 127±67.2umol/L(1.44±0.76mg/dL) on discharge .
The most common aetiology of AKI was a decrease in effective circulating volume (prerenal)(78.17%) secondary to primarily sepsis (44.36%), decompensated heart failure(4.96%), acute coronary syndrome(6.34%), stroke or seizure(7.4%), gastrointestinal bleed(4.22%) and diabetic ketoacidosis (3.52%). Obstructive nephropathy was present in 9.15%. Polypharmacy contributing to AKI was present in 61.97%.
The median length of stay was 8 days (inter-quartile range 5 to 13 days). Renal replacement was required in 13.38%, and 11.27% were admitted to the intensive care unit. On discharge from the hospital, complete renal recovery was seen in 57.75%, residual renal impairment in 22.54% and dialysis dependence in 5.63%. The all-cause mortality was 6.34%.
Conclusion
The incidence of AKI was 5.92% in the study population. Sepsis was a common aetiology. A large proportion of patients had residual renal impairment on discharge, indicating high morbidity with AKI.