- Original article
- Open access
- Published:
Clinical evaluation of acute kidney injury in Al-Zahraa University Hospital, Cairo, Egypt
The Egyptian Journal of Internal Medicine volume 29, pages 16–23 (2017)
Abstract
Background
Acute kidney injury (AKI) is a very common problem. Early detection of injury with initiation of appropriate supportive care remains the mainstay of therapy.
Aim
The aim of the present study was to evaluate the incidence, etiology, prognosis, treatment, and outcome of AKI.
Patients and methods
This was a prospective, observational study of 212 patients (137 men and 75 women) who were admitted in all departments of Al-Zahraa University Hospital with AKI during the period from October 2014 to October 2015. Their ages ranged from 22 to 85 years. We included adults aged more than 18 years who presented with AKI, and we excluded patients on regular dialysis. Serum creatinine, sodium, potassium, urea, calcium, phosphorus and uric acid, complete blood count, pelviabdominal ultrasound, and daily measurement of urine output (UOP) were done. AKI patients were classified according to the RIFLE and Acute Kidney Injury Network staging.
Result
According to the RIFLE criteria, the number of risk, injury, failure, loss, and end-stage renal disease patients were 55 (25.9%), 62 (29.24%), 33 (15.56%), 38 (17.92%), and 24 (11.32%), respectively. According to the Acute Kidney Injury Network staging system, the number of stages I, II, and III patients were 61 (28.7%), 50 (23.5%), and 101 (47.6%), respectively. The length of hospital stay was significantly associated with severity of AKI. The main cause of AKI was dehydration in 82 (38.7%) patients and sepsis in 71 (33.5%). Oliguric patients were 147 (69.34%) and nonoliguric were 65 (30.66%). Moreover, prognosis of patients was complete recovery in 95 (44.81%), partial recovery in 81 (38.21%), and no recovery in 36 (16.98%).
Conclusion
AKI was more common among patients in ICU than those in any other department. Dehydration and sepsis were its leading causes.
References
Parikh A, Shaw A. The economics of renal failure and kidney disease in critically ill patients. Crit Care Clin 2012; 28:99–111.
Wang HE, Muntner P, Chertow GM, Warnock DG. Acute kidney injury and mortality in hospitalized patients. Am J Nephrol 2012; 35:349–355.
Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet 2005; 365:417–430.
Andrew JP, Sayed A. Acute kidney injury: how do we define it? Ann Clin Biochem 2010; 47:4–7.
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute Dialysis Quality Initiative Workgroup: acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8:R204–R212.
Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007 11:R31.
Wijewickrama ES, Ratnayake GM, Wikramaratne C, Sheriff R, Rajapakse S. Incidences and clinical outcomes of acute kidney injury in ICU: a prospective observational study in Sri Lanka. BMC Res Notes 2014; 7:305.
Fan H, Zhao Y, Zhu JH, Song FC. Urine neutrophil gelatinase-associated lipocalin in septic patients with and without acute kidney injury. Ren Fail 2014; 36:1399–1403.
Roberts G, Phillips D, McCarthy R, Bolusani H, Mizen P, Hassan M, et al. Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? Clin Kidney J 2015; 8:673–680
Talaat A, Elshahawy E, ElHammady AM, El-Assal M, Abdullah S. Epidemiology, clinical characteristics and outcome of acute kidney injury in intensive care units in Egyptian patients. Life Sci J 2014; 11: 220–224.
Mehta RL, Burdmann EA, Cerdá J, Feehally J, Finkelstein F, GarcÃa-GarcÃa G, et al. Recognition and management of acute kidney injury in the International Society of Nephrology by25 Global Snapshot: a multinational cross-sectional study. Lancet 2016; 387:2017–2025.
Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med 2008 36:S146–S151.
Clermont G, Acker CG, Angus DC, Sirio CA, Pinsky MR, Johnson JP. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney Int 2002; 62:986–996.
Chawla L, Abell L, Mazhari R, Egan M, Kadambi N, Burke HB, et al. Identifying critically ill patients at high risk for developing acute renal failure. Kid Int 2005; 68:2274–2280.
Santos WJ, Zanetta DM, Pires AC, Suzana MA, Emerson Q, Emmanuel A. Patients with ischemic, mixed and nephrotoxic acute tubular necrosis in intensive care unit. Crit Care 2006; 10:68–76.
Challiner R, James P, Paul L, Catherine F, Alastair J. Incidence and consequence of acute kidney injury in unselected emergency admissions to a large acute UK hospital trust. BMC Nephrol 2014; 15:84.
Xiaoxi Z, Gearoid MM, Steven MB, David WB, Sushrut SW. Incidence, outcomes, and comparisons across definitions of AKI in hospitalized individuals. Clin J Am Soc Nephrol 2014; 9:12–20.
Chijioke A, Makusidi AM, Rafiu MO. Factors influencing hemodialysis and outcome in severe acute renal failure from Ilorin, Nigeria. Saudi J Kidney Dis Transpl. 2012; 23:391–396.
Jinyoung Y, Ji Sung L, Jiyeon L, Jin Seok J, Hyunjin N, Dong Cheol H, Soon H. Relationship between duration of hospital-acquired acute kidney injury and mortality: a prospective observational study. Korean J Intern Med 2015; 30:205–211.
Rifkin DE, Coca SG, Kalantar-Zadeh K. Does AKI truly lead to CKD? J Am Soc Nephrol 2012; 23:979–984.
Bello BT, Busari AA, Amira CO, Raji YR, Braimoh RW. Acute kidney injury in Lagos: pattern, outcomes, and predictors of in-hospital mortality. Niger J Clin Pract 2017; 20:194–199.
Lopes JA, Jorge S, Resina C, Santos C, Pereira A, Neves J, et al. Acute kidney injury in patients with sepsis. Crit Care 2007; 11:411.
Cruz DN, Bolgan I, Perazella MA, Bonello M, de Cal M, Corradi V, et al. North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with RIFLE criteria. Clin J Am Soc Nephrol 2007; 2:418–425.
Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol 2007; 2: 431–439.
Bouchard J, Acharya A, Cerda J. A prospective international multicenter study of AKI in the intensive care unit. Clin J Am Soc Nephrol 2015; 8: 1324–1331.
Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 2015; 41: 1411–1423.
Jung H-Y, Lee J-H, Park Y-J, Kim S-U, Lee K-H, Choi J-Y, et al. Duration of anuria predicts recovery of renal function after acute kidney injury requiring continuous renal replacement therapy. Korean J Inter Med 2016; 31:930–937.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Ahmed, L.I., Mansour, H.H., Hussen, A. et al. Clinical evaluation of acute kidney injury in Al-Zahraa University Hospital, Cairo, Egypt. Egypt J Intern Med 29, 16–23 (2017). https://doi.org/10.4103/ejim.ejim_3_17
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/ejim.ejim_3_17