062 PREVALENCE OF ACUTE KIDNEY INJURY AND SEPSIS IN A MALAYSIAN INTENSIVE CARE SETTING

Abstract

Introduction Acute Kidney Injury (AKI) is common in patients admitted to the intensive care unit, occurring in 30 to 60% of patients. The high incidence of AKI in our population may be attributed to sepsis. Sepsis is the leading cause of ICU admission. The Malaysian Registry of Intensive Care (MRIC), an annual ICU audit performed in all Malaysian ICUs. This registry serves as an excellent avenue to explore the incidence of septic AKI in our local ICU. Methods This retrospective cohort study extracted de-identified data from the Malaysian Registry of Intensive Care (MRIC) for patients admitted to Hospital Tengku Ampuan Afzan between January and December 2014. The study was registered under the NMRR (NMRR-14-1938-23183) and approved by the ethics committee. AKI was defined as doubling of serum creatinine from baseline value. Results A total of 1059 ICU admissions were analysed. Of these 230 (21.7%) had AKI and 253 (23.9%) had sepsis within 24 hours of admission. Patients with AKI were older and had higher severity of illness compared to those without AKI (p<0.0001). Diabetes mellitus, chronic renal failure and hypertension were more common in patients with AKI. Twenty percent of patients received dialysis, and 23% died. Of those who survived, AKI patients had longer duration of mechanical ventilation, length of ICU and hospital stay (p<0.0001). Seventy-three percent (n=168) of patients with sepsis had AKI (p<0.0001). Conclusions AKI is common in our ICU, with higher morbidity and mortality. Risk factors of AKI includes age, severity of illness, the presence of sepsis and pre-existing diabetes mellitus, chronic renal failure, and hypertension. Future analysis will explore a larger cohort of data involving four tertiary hospitals over a five-year duration.