070 ACUTE KIDNEY INJURY IN CORONARY CARE UNIT: PREVALENCE, AETIOLOGIES AND OUTCOMES

Abstract

Category: Research in AKI (Basic, translational, clinical including clinical trials) Presenter: Dr MIN HUI TAN Keywords: Acute kidney injury, coronary care unit, prevalence, aetiology Acute kidney injury (AKI) is an independent risk factor for mortality in the critically ill patients. While many studies are conducted in the Intensive Care Unit setting, little is known about AKI in the Coronary Care Unit (CCU) patients. Furthermore, data on Asian patients are limited. To determine the prevalence, aetiologies of AKI and clinical outcomes of these patients. This was a prospective observational study looking at patients who were admitted in CCU and Cardiac Rehabilitation Ward (CRW) Kuala Lumpur Hospital from February 2017 to April 2017. AKI was defined by increase in serum creatinine > 0.3mg/dL (26.5μmol/L) within 48 hours. There were 195 admissions; of which 22 (11.3%) patients fulfilled criteria for developing AKI while in CCU and CRW. Two thirds were male; mean age was 53.4 years (SD 13.4). Heart failure was the main diagnosis of admission (68.2%) therefore accounted for the most common aetiology of AKI (72.7%). Although AKI resolved in 15 patients (68.2%), only 14 (63.6%) survived the hospitalisation. All 8 patients who died were male (p=0.022). Comparing patients who survived and died, length of hospital stay was longer (8 vs 19.5 days, p=0.05), glomerular filtration rate was lower (27.5 vs 18.3 ml/min, p=0.026) and more patients required renal replacement therapy (p=0.01) in the mortality group. Conversely, there were no associations between survival of the patients with mechanical ventilation, inotropic support and use of medications like renin angiotensin system blockers and diuretics. AKI is common and has high mortality rate. Limited by the small sample size due to short duration, this study provides an early insight into the prevalence, aetiologies and risk factors for AKI in CCU patients.