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Kidney Week

Abstract: FR-PO087

Influence of Acute Kidney Disease on the Incidence of AKI and Patient Outcomes in Critically Ill Patients Admitted to the Intensive Care Unit

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Rhee, Harin, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Kim, Dong Eon, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Jo, Eunmi, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Lee, Yeji, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Kim, Taeil, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  • Kim, Il Young, Pusan National University School of Medicine, Busan, Korea (the Republic of)
Background

The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline for acute kidney injury (AKI) proposed the concept of acute kidney disease (AKD), however, its impact on critically ill patients is rarely studied. The aim of this study is to investigate the influence of baseline AKD on the incidence of AKI and patient outcomes in critically ill patients admitted to intensive care unit (ICU).

Methods

This is a retrospective study based on the electronic medical record-extracted ICU cohorts in two 3rd affiliated hospitals in South Korea. We retrospectively categorized baseline kidney function status as no kidney disease (NKD), AKD, and chronic kidney disease (CKD) based on the eGFR levels. AKI was defined based on the KDIGO serum creatinine criteria. The outcome measurements were the incidence of AKI in the ICU and in-hospital mortality.

Results

A total of 7,153 patients were included. The median age was 67 (18-110) years, and 57.6% were male. In all, baseline NKD, AKD, and CKD were seen in 4,792 (66.6%), 926(12.9%), and 1,465(20.5%) patients, respectively. During the ICU stay, AKI was observed in 2,461(34.4%) patients, which was more frequent in AKD [OR 2.354(1.996-2.776)] and CKD [OR 2.347(2.028-2.716)] compared to NKD (Fig 1A). During the median 16(9, 23) days of hospital stay, 819(11.4%) were dead. The in-hospital mortality rate was 1.546(1.328-1.800) folds higher in patients with AKI regardless of the baseline kidney function status, whereas, in patients without AKI, the risk of mortality was 2.176(1.625-2.915) folds higher in AKD compared to NKD (Fig 1B).

Conclusion

AKD was observed in 12.9% of ICU-admitted patients, and it was associated with a higher risk for incident AKI and in-hospital mortality. This study implies the significance of recognizing AKD in the management of ICU patients.

Funding

  • Government Support – Non-U.S.