Acute kidney injury in patients with invasive mechanical ventilation in Guantanamo, 2018-2019
Keywords:
acute kidney failure, acute kidney injury, acute kidney damageAbstract
Introduction: acute kidney injury is a very common complication in the intensive care units, especially in patients with invasive mechanical ventilation.
Objective: to characterize acute kidney damage in patients with invasive mechanical ventilation in the intensive care unit at the General Teaching Hospital ¨Dr. Agostinho Neto¨ within the period 2018-2019.
Method: a descriptive, retrospective and longitudinal study approved by the Ethics Committee was carried out. The study population was constituted by the total of patients with the diagnosis, according to the Acute Kidney Injury Network (AKIN). Characteristics and variables like: reason for the invasive mechanical ventilation, its duration, hemodialysis, and status of the patient at time of discharge were taken into account, along with the characteristics of the kidney injury (stages and etiology).
Results: 47.5 % of the patients treated with life support showed acute kidney injury, especially the ones with more than a week of mechanical ventilation (68.4 %). The risk of death was higher in the patients with mechanical ventilation and hemodialysis. In the patients with stage 2 and 3 of the scale used for kidney injury presented 3 times more risk compared to those who did not require these treatments. Sepsis was the main cause of acute kidney injury (69.4 %).
Conclusions: the use of invasive mechanical ventilation and acute kidney injury are deeply related to each other, both of them constitute main issues in the variables of mortality.
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References
2. Abarca RB, Mestas RMM, Widerström IJ, Lobos PB, Vargas UJ. Un enfoque actual para el diagnóstico precoz y tratamiento de la insuficiencia renal aguda. Medwave [en línea]. 2020 [citado 7 Sep 2020]; 20(5):e7928. Doi: https://doi.org/10.5867/medwave.2020.05.7928
3. Ostermann M, Joannidis M. Acute kidney injury 2016: diagnosis and diagnostic workup. Crit Care [en línea]. 2016 [citado 7 Sep 2020]; 20(1):299. Doi: https://doi.org/10.1186/s13054-016-1478-z
4. Altamirano WG, Arias CP, Saltos SS, Rodríguez MQ Segale AB. Clasificación RIFLE vs AKIN para pronóstico de insuficiencia renal aguda durante la sepsis en pacientes hospitalizados en UCI en el Hospital Teodoro Maldonado Carbó. CMAJ [en línea]. 2018 [citado 07 Sep 2020]; 190:E1070-80. Doi: https://doi.org/10.1503/cmaj.171382
5. Álvarez RS, Montero SE, Cabrera HJE, González LEC, Rodríguez GYL. Factores clínico-epidemiológicos relacionados con sepsis en edades pediátricas. Rev Ciencias Méd [en línea]. 2016 [citado 7 Sep 2020]; 20(1):36-45. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S1561-31942016000100015&lng=es&nrm=iso
6. Negi S, Koreeda D, Kobayashi S, Yano T, Tatsuta K, Mima T, et al. Acute kidney injury: Epidemiology, outcomes, complications, and therapeutic strategies. Semin Dial [en línea]. 2018 [citado 7 Sep 2020]; 31(5):519-527. Doi: https://doi.org/10.1111/sdi.12705
7. Joannidis M, Druml W, Forni LG, Groeneveld ABJ, Honore PM, Hoste E, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017: Expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine. Intens Care Med [ en línea]. 2017 [citado 7 Sep 2020]; 43(6):730-749. Doi en: https://doi.org/10.1007/s00134-017-4832-y
8. Makris K, Spanou L. Acute Kidney injury: definition, pathophysiology and clinical phenotypes. Clin Bioc Rev [en línea]. 2016 [citado 7 Sep 2020]; 37(2):85-98. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/28303073?dopt=Abstract
9. Chen H, Busse LW. Novel Therapies for acute kidney injury. Kidney Int Rep [en línea]. 2017 [citado 7 Sep 2020]; 2(5):785-799. Doi: https://doi.org/10.1016/j.ekir.2017.06.020
10.Muñiz OP. Factores pronósticos en el fracaso renal agudo. Rev Cubana Med Int Emerg [en línea]. 2017 [citado 7 Sep 2020]; 3(1):10-12. Disponible en: http://bvs.sld.cu/revistas/mie/vol3_4_04/mie09404.pdf
11.Rechene BJ, Fernández P, Douthat W Fallo renal agudo en unidades críticas. Factores de riesgo y mortalidad. Rev Nefrol Diál Trasp [en línea]. 2019 [citado 7 Sep 2020]; 38(3):67-78. Disponible en: https://www.revistarenal.org.ar/index.php/rndt/article/view/353/356
12.Fayad AII, Buamscha DG, Ciapponi A. Timing of renal replacement therapy initiation for acute kidney injury. Cochrane Database Syst Rev [en línea]. 2018 [citado 7 Sep 2020]; 18(12):CD010612. Doi: https://doi.org/10.1002/14651858.CD010612.pub2
13.Xiao L, Jia L, Li R, Zhang Y, Ji H, Faramand A. Early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients: A systematic review and meta-analysis. PLoS One [en línea]. 2019 [citado 7 Sep 2020]; 14(10):e0223493. Doi: https://doi.org/10.1371/journal.pone.0223493
14.Regueira T, Andresen M, Mercado M, Downey P. Fisiopatología de la insuficiencia renal aguda durante la sepsis. Med Intens [en línea]. 2011 [citado 7 Sep 2020]; 35(7):424-432. Doi: https://doi.org/1016/j.medin.2011.03.011
15.Hasshemian SM, Jamaati H, FarzaneganBidgoli B, Farrokhi FR, Malekmohammad M, Roozdar S, et al. Outcome of kidney injury in critical care unit based on AKI Network. Tanaffos [en línea]. 2016 [citado 7 Sep 2020]; 15(2):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27904540
16.Núñez A, González L. Evaluación de insuficiencia renal aguda según los criterios “RIFLE” en pacientes ingresados en terapia intensiva. Rev Cubana Med Int Emer [en línea]. 2015 [citado 7 Sep 2020]; 14(3):[aprox. 10 p.]. Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/106
17.Boltansky A, Bassa C, Melania S, Sepúlveda A, Maldonado I, Postigo J, et al. Incidencia de la injuria renal aguda en unidad de paciente crítico y su mortalidad a 30 días y un año. Rev Med Chile [en línea]. 2015 [citado 7 Sep 2020]; 143: 1114-1120. Disponible en: https://scielo.conicyt.cl/pdf/rmc/v143n9/art03.pdf
18.Donoso FA, Arriagada SD, Cruces RBP. Intercomunicación pulmón-riñón en el paciente crítico. Rev Chil Ped [en línea]. 2015 [citado 7 Sep 2020]; 86(5):309-317. Doi: http://dx.doi.org/10.1016/j.rchipe.2015.07.009
19.Huidobro E JP, Tagle R, Guzmán AM. Creatinina y su uso para la estimación de la velocidad de filtración glomerular. Rev Med Chil [en línea]. 2018 [citado 7 Sep 2020]; 146(3):344-350. Doi: https://doi.org/10.4067/s0034-98872018000300344
20.Herrera GME, Seller G, Más FS, Pérez CC, Villa DP, Celaya LM. Lesión renal aguda: nefropatía en la unidad de cuidados intensivos. Med intens [en línea]. 2016 [citado 7 Sep 2020]; 40(6):[aprox. 8p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0210569116300948?via3Dihub