Morbidity and mortality for acute kidney failure in the intensive care unit of the General Teaching Hospital ¨Dr. Agostinho Neto¨
Keywords:
acute kidney injury, acute renal failure, acute renal damage, intensive care unitAbstract
Introduction: acute kidney injury in the intensive care unit in the General Teaching Hospital ¨Dr. Agostinho Neto¨ in Guantanamo has not been characterized.
Objective: to characterize this disease in patients in the intensive care unit in the mentioned institution in the period 2018-2019.
Method: a descriptive, retrospective and longitudinal study was undertaken, all approved by the ethics committee. The study population was made out of the total amount of the patients diagnosed according to the classification of the Acute Kidney Injury Network (AKIN). The variables taken into account were: age, gender, comorbidity, etiology, time in the intensive care unit, requirement for hemodialysis and status of the patient at the time of discharge, plus the stages of the acute kidney injury according to the AKIN scale.
Results: acute kidney injury was diagnosed in the 35.6% of the patients, especially in male patients (56.7%) with ages between 66.3 ± 24.3 years. 41.4% of the patients suffered of systemic arterial hypertension. Stage 1 was found in the 48.9% of the cases, and sepsis was the main cause in 69.4%. Mortality at the time of discharge represented the 16.4%; and after the following 30 days went up to 25.4%. Hemodialysis was required in the 13.8% of the patients; in wich the risk of death was significatively higher.
Conclusions: there is a high number of patients with acute kidney injury in the intensive care unit, and it was really useful the scale implemented for diagnosis and evaluation of the severity of the condition and the prognosis of the patients.
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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. Salgado G, Landa M, Masevicius D, Gianassic S, San Román JE, Silvad L. Insuficiencia renal aguda según RIFLE y AKIN: estudio multicéntrico. Med Intens [en línea]. 2014 [citado 7 Sep 2020]; 38(5):271-7 Disponible en: http://www.medintensiva.org/es/vol-38-num-5/sumario/S0210569114X00045/
4. 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
5. Cinesi GC, Vigil VM, Antonio GMM, Serrano NJM, Rico LLMJ. Mortalidad y fracaso renal agudo en pacientes con ventilación no invasiva. Medicina (Buenos Aires) [en línea]. 2019 [citado 7 Sep 2020]; 79:367-372. Disponible en: https://www.medicinabuenosaires.com/revistas/vol79-19/n5/Gomez.pdf
6. Chen H, Busse LW. Novel Therapies for acute kidney injury. KidneyInt Rep. [en línea] 2017 [citado 7 Sep 2020]; 2(5):785-799. Doi: https://doi.org/10.1016/j.ekir.2017.06.020
7. 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
8. 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
9. 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
10.Álvarez RS, Montero SE, Cabrera HJE, González LEC, Rodríguez GYL. Factores clínico-epidemiológicos relacionados con sepsis en edades pediátricas. Rev Cienc 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
11.Hasshemian SM, Jamaati H, Farzanegan Bidgoli 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 07 Sep 2020]; 15(2):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27904540
12.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
13.Rechene BJ, Fernández P, Douthat W. Fallo renal agudo en unidades críticas. Factores de riesgo y mortalidad. Rev Nefrol Diál Traspl [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
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.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
16.Makris K, Spanou L. Acute Kidney injury: definition, pathophysiology and clinical phenotypes. Clin Biochem Rev [en línea]. 2016 [citado 7 Sep 2020]; 37(2):85-98. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/28303073?dopt=Abstract
17.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: https://doi.org/10.1007/s00134-017-4832-y
18.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
19.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. 8 p.]. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0210569116300948?via3Dihub
20.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