April 2017 Vol. 5 No.4

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Original Research Article

Incidence of Community- Acquired Versus intensive care unit Acquired Acute Kidney Injury in Two Tertiary intensive care units among aged patients

Remon Asaad Nasr MD¹, Nermien Naim Adly MD² and Rania Mohammed Abou-Hashem, MD^2*

¹Anaesthetist, EL Matarya Teaching Hospital, Cairo, Egypt.
²Associate Professor, Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

*Corresponding author’s E-mail: rania_geriatric@yahoo.com, raniaabouhashem_ger@med.asu.edu.eg
Tel.: 00966544103388

Accepted April 04, 2017

Abstract

Acute Kidney Injury is increasing over the last years despite advances in health care system. Elderly had higher chances of experiencing acute kidney injury with devastating effects. A prospective study was conducted on elderly aged ≥ 60 years who were admitted to two intensive care units, over 6 months. Acute kidney injury was diagnosed based on Kidney Disease: Improving Global Outcomes criteria, 2012. All patients admitted to any of the two intensive care units with acute kidney injury, community acquired acute kidney injury (CA.AKI) or developed acute kidney injury during the stay, intensive care unit acquired AKI (ICUA.AKI), were identified. The study included 196 critically ill elderly patients. Their mean age was 68.2± 5.5. The incidence of Acute Kidney Injury “AKI” was 22.4%, 16.3% had CA.AKI and 6.1% had ICUA.AKI. Patients with AKI had significantly higher age and baseline renal failure on dialysis and higher prevalence of risk factors including septic shock, hypovolemia and anemia. Regarding outcomes, patients with AKI had significantly worse SOFA, and more discharge with new acute kidney disease “AKD”. In ICUA.AKI, septic shock, diuretic use and higher age were the significant predictors for the occurrence of AKI. In CA.AKI, hypovolemia, older age and lower hemoglobin were the significant predictors for the occurrence of AKI.

Keywords: Acute kidney injury, Critically ill, Elderly, Predictors, Septic shock.