107 A SINGLE CENTRE INCIDENCE, RISK FACTORS AND SHORT TERM OUTCOMES OF ACUTE KIDNEY INJURY IN ADULTS AT HOSPITAL SULTANAH NUR ZAHIRAH

Abstract

Category: Epidemiology and Outcomes from AKI Presenter: Dr NURUL AIN YUSOF Keywords: Acute Kidney Injury, Incidence, Risk Factors, Outcomes The epidemiology of Acute Kidney Injury (AKI) in developing country is under reported. The rate of AKI has increased with high mortality. Age, evidence of chronic kidney disease, sepsis, multiple comorbidities (Diabetes Mellitus, Hypertension, Ischeamic Heart Disease) and multi organ dysfunction at the initial presentation were among risk factors for AKI. To determine single centre incidence, risk factors and analysis of association for short term outcomes and risk factors of AKI . This is a retrospective cross sectional cohort analysis of patient diagnosed with AKI admitted to medical and non-medical ward at Hospital Sultanah Nur Zahirah from 1st June 2015 to 31th December 2015. All subjects with abnormal serum creatinine were screened via computerized Hospital Information System(HIS) and recruited in the study based on the inclusion criterias. The demographic criterias, risk factors, management and short term outcomes of AKI were recorded and analyzed using Pearson's Chi square and the association between the outcome and the risk factors were analyzed with multiple logistic regression. A total of 210 patients admitted with AKI in a given study period. The cumulative incidence of AKI in our cohort is 11%. Of these, 30%( 63) were males and 70%( 147) were females and 56% of them (119) were more than 60 years of age. Identified risk factors for AKI are age, cardio renal syndromes, sepsis, drugs related and post-operative period with sepsis and post-operation had significant p value of 0.002 and 0.019. Short term outcomes include renal recovery in 28.5%, 3.8% had surgical intervention, 12.8% required dialysis support and 54.8% patients died (of which 20 requires renal replacement therapy). Main cause of death is septiceamia shock (56%). Sepsis has significant association with outcome i.e mortality and abnormal renal function with p value of 0.001(95% CI: 1.6-4.9) and 0.03 (95%CI: 0.25 -0.93). Renal recovery is significantly associated with gender, cardio-renal syndromes and sepsis with p value of 0.03 (95%CI: 0.21-0.94), 0.01(95% CI: 0.03-0.62) and 0.008 (95% CI: 0.22- 0.80) respectively. AKI cause significant morbidity and mortality for at risks population. This database perhaps would initiate more studies in the area as early recognition would certainly improve AKI outcomes.