Abstract
BackgroundAcute kidney injury (AKI) newly-emerged in intensive care unit (ICU), has not been thoroughly studied in previous researches, is likely to differ from AKI developed before ICU admission. This study aimed to evaluate the incidence, risk factors, clinical features and outcome of new-onset AKI in critically ill patients.MethodsThe data of present study derived from a multicenter, prospective cohort study in17 Chinese ICUs (January 2014 - August 2015). The incidence, risk factors, clinical features and survival analysis of new-onset AKI were assessed.ResultsA total of 3374 adult critically ill patients were eligible. The incidence of new-onset AKI was 30.0 % (n = 1012). Factors associated with a higher risk of new-onset AKI included coronary heart disease, hypertension, chronic liver disease, use of nephrotoxic drugs, sepsis, SOFA score, APACHEII score and use of vasopressors. The new-onset AKI was an independent risk factor for 28-day mortality (adjusted hazard ratio, 1.643; 95 % CI, 1.370–1.948; P < 0.001). 220 (21.7 %) patients received renal replacement therapy (RRT), 71 (32.3 %) of them were successfully weaning from RRT. More than half of the new-onset AKI were transient AKI (renal recovery within 48 h). There was no statistical relationship between transient AKI and 28-day mortality (hazard ratio, 1.406; 95 % CI, 0.840–1.304; P = 0.686), while persistent AKI (non-renal recovery within 48 h) was strongly associated with 28-day mortality (adjusted hazard ratio, 1.486; 95 % CI, 1.137–1.943; P < 0.001).ConclusionsNew-onset AKI is common in ICU patients and is associated with significantly higher 28-day mortality. Only persistent AKI, but not transient AKI is associated with significantly higher 28-day mortality.
Highlights
Acute kidney injury (AKI) newly-emerged in intensive care unit (ICU), has not been thoroughly studied in previous researches, is likely to differ from AKI developed before ICU admission
Study setting and population The retrospective analysis based on database of a prospective cohort study about sepsis epidemiology sponsored by China Critical Care Sepsis Trial (CCCST) workgroup, which was performed in 17 Chinese ICUs between January 1st, 2014 and August 31st, 2015
The definition of new-onset AKI in our study might prevent the influence of duration of AKI before ICU admission, which facilitated the precise grouping of transient AKI and persistent AKI
Summary
Acute kidney injury (AKI) newly-emerged in intensive care unit (ICU), has not been thoroughly studied in previous researches, is likely to differ from AKI developed before ICU admission. This study aimed to evaluate the incidence, risk factors, clinical features and outcome of new-onset AKI in critically ill patients. Acute kidney injury (AKI) occurs in more than 50 % of intensive care patients and is associated with increased risks of in-hospital mortality and long-term chronic kidney disease [1,2,3]. Most AKI appears in the first 72 h after patients are transferred to intensive care unit (ICU) [5,6,7], but some critically ill patients may already have kidney damage before admission to ICU. The appearance time of kidney injury implies the difference in causes and severity of the disease, which results in different clinical manifestations and outcomes. Few studies have defined the exact time when AKI appears
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
