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Kidney Week

Abstract: SA-PO0031

Prevalence and Mortality of Critically Ill Patients with AKI in Peru

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Nombera, Natalia R., The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Fernandez Merjildo, Diana, Universidad Peruana Cayetano Heredia, Lima District, Lima Region, Peru
  • Leon, Cristian Paul, Hospital Nacional Cayetano Heredia, Lima District, Lima Region, Peru
Background

Acute kidney injury (AKI) is a heterogeneous clinical syndrome affecting approximately 10–15% of hospitalized patients, with over half of cases occurring in the intensive care unit (ICU). It is associated with increased morbidity and mortality in both the short and long term. Most of the available data come from international settings, where clinical and epidemiological characteristics—as well as access to healthcare resources—differ significantly. This study aims to determine the prevalence and mortality of AKI among critically ill patients admitted to a Peruvian ICU.

Methods

A cross-sectional study was conducted at Hospital Nacional Cayetano Heredia from 2016 to 2024. We included patients aged 18 years or older who were admitted to the ICU and developed de novo AKI during hospitalization, as defined by the KDIGO guidelines. Clinical and demographic data were collected, including acute conditions that developed during the ICU stay and patient survival status. Descriptive statistics were used to summarize the data. An exploratory analysis of time-dependent variables was performed using Cox proportional hazards models and Kaplan–Meier survival curves to identify factors associated with mortality.

Results

819 patients were included. The median age was 57 years (IQR: 40.5–72), and 42.1% were female. Surgical admissions represented 43.5%, and the median (IQR) ICU stay was 6 (2–13) days. Hypertension (15.1%), diabetes (10.9%), and CKD (6.6%) were the most common comorbidities. At admission, septic shock (48.8%) and acute respiratory failure on mechanical ventilation (81.2%) were the predominant clinical conditions. The overall prevalence and mortality ratios were 13.3% and 33.6% respectively. The median survival time was 23 days. Older age (HR: 1.49, 95% CI: 1.17–1.89; p = 0.001) and shock at admission (HR: 2.33, 95% CI: 1.78–3.06; p < 0.001) were significantly associated with increased mortality, while hypertension was linked to reduced mortality risk (HR: 0.55, 95% CI: 0.36–0.83; p = 0.004).

Conclusion

This is the most comprehensive study on AKI among critically ill patients in Peru. Despite lower prevalence compared to international reports, mortality was comparable, with older age and shock at admission as significant predictors. These findings offer valuable insights to guide clinical decision-making and improve outcomes in intensive care settings.

Digital Object Identifier (DOI)