Epidemiology, patterns of care and prognosis of acute kidney injury in critically ill patients: A multicenter study in Argentina (The EPIRA study)

被引：3

作者：

Birri, Paolo Nahuel Rubatto ^{[1
]}

Giannoni, Roberto ^{[2
]}

Furche, Mariano ^{[3
]}

Nahra, M. ^{[4
]}

Gallardo, M. Arce ^{[2
]}

Segui, Gabriela ^{[5
]}

Ilutovich, Santiago ^{[6
]}

Olmos, Matias ^{[7
]}

Birri, Pilar ^{[8
]}

Romano, Maria ^{[9
]}

Ayala, Patricia ^{[10
]}

Petrochelli, Veronica ^{[11
]}

Huespe, Luis ^{[12
]}

Banegas, David ^{[1
]}

Gomez, Alejandro ^{[3
]}

Zakalik, Graciela ^{[13
]}

Lipovestky, Fernando ^{[14
]}

Montefiore, Juan Pablo ^{[15
]}

Galletti, Cayetano ^{[16
]}

Pendino, Carlos ^{[17
]}

Vera, Mariana ^{[18
]}

Mare, Sebastian ^{[19
]}

Bergallo, Laura ^{[20
]}

Fernandez, Gabriela ^{[21
]}

Campassi, Maria Luz ^{[22
]}

Rios, Fernando ^{[23
]}

Saul, Pablo ^{[24
]}

Bonsignore, Pablo ^{[25
]}

Gallardo, Beatriz ^{[26
]}

Gimenez, Mirta ^{[27
]}

Estenssoro, Elisa ^{[28
]}

机构：

[1] Sanatorio Otamendi, Buenos Aires, Argentina

[2] Hosp Reg Ramon Carrillo, Santiago Del Estero, Argentina

[3] Sanatorio Arcos, Buenos Aires, Argentina

[4] Hosp Espanol, Buenos Aires, Argentina

[5] Hosp Dr Luis Guemes, Buenos Aires, Argentina

[6] Sanatorio Trinidad Mitre, Buenos Aires, Argentina

[7] Hosp Univ Fdn Favaloro, Buenos Aires, Argentina

[8] Clin Sucre, Cordoba, Argentina

[9] Clin San Agustin, Neuquen, Argentina

[10] Hosp San Bernardo, Salta, Argentina

[11] Ctr Integral Salud, La Banda, Santiago Del Es, Argentina

[12] Hosp Escuela Gen San Martin, Corrientes, Argentina

[13] Hosp Luis Lagomaggiore, Mendoza, Argentina

[14] Hosp Univ UAI, Buenos Aires, Argentina

[15] Hosp Interzonal Agudos San Martin, La Plata, Buenos Aires, Argentina

[16] Sanatorio Allende, Cordoba, Argentina

[17] Hosp Centenario, Rosario, Santa Fe, Argentina

[18] Hosp Cent, Mendoza, Argentina

[19] Hosp Zona, Esquel, Chubut, Argentina

[20] Sanatorio MAPACI, Rosario, Santa Fe, Argentina

[21] Sanatorio Pueyrredon, Mar Del Plata, Buenos Aires, Argentina

[22] Clin La Pequena Familia, Junin, Buenos Aires, Argentina

[23] Sanatorio Las Lomas, Pilar, Buenos Aires, Argentina

[24] Policlin UOM, Buenos Aires, Argentina

[25] Clin San Martin, Cordoba, Argentina

[26] Hosp Cordoba, Cordoba, Argentina

[27] Hosp Centenario, Gualeguaychu, Entre Rios, Argentina

[28] Minist Salud Prov Buenos Aires, Escuela Gobierno Salud, Buenos Aires, Argentina

来源：

JOURNAL OF CRITICAL CARE | 2023年 / 78卷

关键词：

Critical care; Epidemiology; Patterns of care Prognosis; Patterns of care; Acute kidney injury; RENAL REPLACEMENT THERAPY; LATIN-AMERICA; MANAGEMENT; CREATININE; MORTALITY; UNIT;

D O I：

10.1016/j.jcrc.2023.154382

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Acute kidney injury (AKI) is associated with high morbidity and mortality rates in the intensive care unit (ICU). In low-and middle-income countries (LMICs), epidemiological information about this condition is still scarce. Our main objective was to characterize its epidemiology, prognosis, and its treatment.Methods: This multicenter prospective cohort study included 1466 patients from 35 ICUs during 6 months in Argentina in 2018. Risk factors and outcomes in patients with and without AKI, and between AKI on admission (AKIadm) and that developed during hospitalization (AKIhosp) were analyzed.Results: AKI occurred in 61.3% of patients (900/1466); 72.6% were AKIadm and 27.3% AKIhosp. Risk factors were age, BMI, arterial hypertension, cardiovascular diseases, diabetes, SOFA, APACHE II, dehydration, sepsis, vasopressor use, radiocontrast, diuresis/h and mechanical ventilation. Independent predictors for AKI were sepsis, diabetes, dehydration, vasopressors on admission, APACHE II and radiocontrast use. Renal replacement therapies (RRT) requirement in AKI patients was 14.8%. Hospital mortality in AKI vs. non-AKI was 38.7% and 23.3% (p < 0.001); and in AKIadm vs. AKIhosp, 41.2% and 37.8% (p = 0.53).Conclusions: ICU-acquired AKI has high incidence, complications and mortality. Risk factors for AKI and RRT utilization were similar to those described in other epidemiological studies. AKIadm was more frequent than AKIhosp, but had equal prognosis.

引用

页数：9

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