Epidemiological Survey Of Acute Kidney Injury In Hospitalized Patients

ObjectiveTo determine the morbidity, the constitution of causes and the prognosis of acutekidney injury (AKI)among hospitalized patients in a integrated tertiary hospital, andto find out the risk factors associated with the outcome for better understanding andpreventing AKI among inpatients.MethodsAll the hospitalized patients were screened by Lab Administration Network ofThe First Affiliated Hospital of Fujian Medical University from Jan. to Dec. in2011.Study cohort was comprised of all the patients with AKI defined By Acute KidneyInjury Network(AKIN)and with complete clinical data recorded. The incidence,etiology and distribution characteristics, prognosis of AKI in hospitalized patientswere retrospectively analyzed. Logistic regression analysis was used to investigate therisk factors of clinical and renal outcome in AKI patients．ResultsThere were58521admissions during the study period and703met with thediagnostic criteria of acute kidney injury (AKI). The morbidity of AKI was1.20%.The mortality was24.61%in patients with AKI. The ratio of male to female was1.61:1. The average of age was (59.68±16.88) years old. There was21.48%AKI found insurgical department,43.93%in internal medicine department,28.31%incomprehensive ICU and0.28%in obstetric and gynecologic department. Causes ofprerenal were main ones, which was61.17%,28.73%and10.10%respectively. Elderwere in the majority,30.30%patients were older adults aged between40and60years,and53.77%were older than60years of age. The mortality in renal replacementtherapy group was higher than that in conservative therapy group (P<0.05).Multivariate Logistic regression analysis showed that the stage of AKI (OR=1.468, P=0.002,95%CI=1.156-1.864), hyphemia (OR=1.358,P=0.012,95%CI=1.070-1.723),the use of diuretics (OR=3.630, P<0.001,95%CI=1.970-6.688), Chronic KidneyDisease(OR=2.839, P<0.001,95%CI=1.633-4.936), respiratory failure(OR==2.813,P=0.002,95％CI=1.476-5.358), hypotension(OR=3.634, P<0.001,95%CI=2.070-6.378) and the number of failure organs except kidney (OR=1.559, P=0.007,95%CI=1.132-2.147) were independent risk factors for death among AKI patients. The stageof AKI (OR=1.818, P<0.001,95%CI=1.431-2.308), the number of failure organsexcept kidney (OR=1.427, P=0.001,95%CI=1.163-1.751), cancer (OR=2.262, P=0.001,95%CI=1.380-3.707) and the use of diuretics (OR=2.511, P=0.002,95%CI=1.397-4.514) were independent risk factors for renal loss.ConclusionsAKI is one of the most common complications in hospitalized patients. Causesthat prerenal are main ones，elder is in the majority. The mortality and the rate of renalloss are significantly increased in patients with AKI. AKI can be taken as the basis forjudging the illness severity. The stage of AKI, the number of failure organs exceptkidney and the use of diuretics are the common factors for renal loss and death amongAKI patients. The hyphemia, Chronic Kidney Disease, respiratory failure, andhypotension were independent risk factors for death among AKI patients; The cancerwere independent risk factors for renal loss. AKI has a high morbidity and mortality,which suggests that earlier diagnosis of AKI with the criteria of AKIN can promoteearlier resolution and improve prognosis.