SUN-174 EPIDEMIOLOGY AND OUTCOME OF ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT PATIENTS IN LAOS: A MULTICENTER, PROSPECTIVE, OBSERVATIONAL STUDY

Abstract

Numerous publications reported the incidence of acute kidney injury (AKI) around the world. However, there is still no any reports of incidence and outcomes of this high burden disease from Laos PDR. The objectives of this study were to determine the incidence of AKI in ICU patients; to characterize the differences in a etiology, illness severity and to determine the factors of AKI and the outcome of AKI among ICU patients in Lao PDR. As part of South Eastasia-AKI (SEA-AKI) study, we collected the data by registration in electronic web-based format from 5 ICU centers across Laos PDR. The data were serially collected on the first 28 days of ICU admission. Standard Kidney Disease Improving Global Outcomes (KDIGO) criteria were used to define AKI incidence. We used mortality at hospital discharge time as the clinical outcome. We also explored the impact of age, gender, co-morbidity disease, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and primary diagnosis to the AKI incidence and outcome. This is the first and the largest prospective observational study of AKI epidemiology in Laos. We have enrolled 1,480 patients from January 1st, 2016 to December 31th, 2016. After exclusion of end stage renal disease patients (n=20), we finally had 1,460 patients in our cohorts. AKI occurred in 508 patients (34.8%; KDIGO stage1- 4.04%; stage2- 10.27%; stage3- 20.48%). The hospital mortality for AKI patients was 59% compared with 41% in non AKI group (P < 0.001). In the multivariable adjusted model, we found that age, hypertension, diabetes, and chronic kidney disease, severity score and the primary diagnosis of renal related disease were independent risk factors for AKI incidence. AKI is very common disease in Laos and yielded high hospital mortality rate. AKI incidence varied by age, gender, disease severity, and primary diagnosis. Early diagnosis and intervention to reduce severity of disease, and early ICU admission will alleviate AKI and improve outcomes