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Kidney Week

Abstract: FR-OR012

Preventing AKI and Improving Outcome in Critically Ill Patients Utilising Risk Prediction Score (PRAIOC-RISKS) – A Pilot Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Abdelaziz, Tarek Samy, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
  • Hussin, Wessam Moustafa, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
  • Elyamny, Mohamed Saber amin, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
  • Fatthy, Moataz, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
  • Fouda, Ragai, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
  • Abdelhamid, Yasser Mohamed, Kasr Alaini Hosp-Cairo university, Giza-Cairo, Egypt
Background

Early detection and management of AKI in medical ICU is an unmet goal. Our study used a risk score to identify patients at high risk of developing AKI and apply timely preventive measures.

Methods

The study was run at two separate medical intensive care units. A recently validated and published risks score, developed by Malhotra and colleagues was used. A risk score was applied to all patients admitted to the ICU during the study period. Eligible patients were adults, who had mental capacity and who did not have AKI at time of recruitment. Patients who had established AKI at the time of recruitment were excluded from the study.
In the (observation) ICU, patients received the standard care. In the (intervention) ICU, high risk patients (risk score ≥5) had very early nephrology review. A package of standardized recommendations was implemented. Measures included optimizing fluid balance, mean arterial pressure, cessation and avoidance of potential nephrotoxic medications and optimal sepsis management. The primary outcome was the incidence of AKI.

Results

During 8 months, we recruited 98 patients in the intervention arm and 108 patients in the observation arm. Baseline characteristics are shown in table 1. There was statistically significant difference in AKI incidence between the two groups (26% in the observation group versus 11% in the intervention group, p=0.002). 30 day-mortality was lower in the intervention group but not statistically significant (25% in the intervention arm versus 32% in the observation arm, p=0.35).

Conclusion

It was feasible to apply very early nephrology intervention to critically ill patient at high risk of developing AKI.The incidence of AKI was significantly lower in the intervention group. Multicentre studies are needed.

Baseline characteristics

30 days Mortality