Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos

Background: Non-critical care Hospital-Acquired Acute Kidney Injury (Non-ICU HA-AKI) is a preventable common complication. Aim: To analyze its risk factors and outcomes in a general hospital ward. Material and Methods: A retrospective paired case-control 1:2 study was carried out from April to De...

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Autores principales:	González G.,Camilo A., Hurtado,Maite, Contreras,Kateir, García,Paola K., Rodríguez,Patricia, Accini,Melisa, Acuña,Paola, Vera,Luis A.
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Acute Kidney Injury Hospital Mortality Inpatients Kidney Diseases Risk Factors
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201390
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spelling	oai:scielo:S0034-988720180012013902019-02-18Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicosGonzález G.,Camilo A.Hurtado,MaiteContreras,KateirGarcía,Paola K.Rodríguez,PatriciaAccini,MelisaAcuña,PaolaVera,Luis A. Acute Kidney Injury Hospital Mortality Inpatients Kidney Diseases Risk Factors Background: Non-critical care Hospital-Acquired Acute Kidney Injury (Non-ICU HA-AKI) is a preventable common complication. Aim: To analyze its risk factors and outcomes in a general hospital ward. Material and Methods: A retrospective paired case-control 1:2 study was carried out from April to December 2014. Non-ICU HA-AKI was defined as those patients who experienced a 1.5-fold, or 0.3 mg/dl rise in serum creatinine after 24 hours of hospitalization. Controls were randomly selected, paired by date of hospital admission and specialty causing the admission. We analyzed short-term outcomes and risk factors. Results: We included 101cases aged 65 ± 16 years (55% women). Mean length of stay at the time of diagnosis of AKI was 7.9 ± 8.9 days. Hospital length of stay was longer in patients with AKI (p < 0.01), The risk for intensive care unit (ICU) admission and mortality were also higher (odds ratio [OR], 2.43 [95% confidence intervals (CI), 1.24 to 4.75)p < 0.01 and OR, 26.2 [95% CI, 8.8 to 104, P < 0.01). In a multivariate analysis, sepsis (OR, 3.64 [95% CI, 1.30 to 10.16] p = 0.013), dehydration (OR, 14.4 [95% CI, 4.49 to 46.19), baseline glomerular filtration (OR, 0.96 [95% CI, 0.94-0.98), contrast medium exposure (OR, 4.33 [95% CI, 1.60 to 11.66), recent exposure to Nonsteroidal Anti-inflammatory Drugs (OR 3.23 [95% CI, 1.22 to 8.52 (p = 0.02)] and Charlson comorbidity index (OR, 1.23 [95% CI, 1.05 to 1.43 (p < 0.01) were independent risk factors for Non-ICU HA-AKI. Conclusions: Non-ICU HA-AKI is associated with a longer hospital stay and higher risk of ICU admission and mortality. Most risk factors are potentially preventable.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.12 20182018-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201390es10.4067/s0034-98872018001201390
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acute Kidney Injury Hospital Mortality Inpatients Kidney Diseases Risk Factors
spellingShingle	Acute Kidney Injury Hospital Mortality Inpatients Kidney Diseases Risk Factors González G.,Camilo A. Hurtado,Maite Contreras,Kateir García,Paola K. Rodríguez,Patricia Accini,Melisa Acuña,Paola Vera,Luis A. Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
description	Background: Non-critical care Hospital-Acquired Acute Kidney Injury (Non-ICU HA-AKI) is a preventable common complication. Aim: To analyze its risk factors and outcomes in a general hospital ward. Material and Methods: A retrospective paired case-control 1:2 study was carried out from April to December 2014. Non-ICU HA-AKI was defined as those patients who experienced a 1.5-fold, or 0.3 mg/dl rise in serum creatinine after 24 hours of hospitalization. Controls were randomly selected, paired by date of hospital admission and specialty causing the admission. We analyzed short-term outcomes and risk factors. Results: We included 101cases aged 65 ± 16 years (55% women). Mean length of stay at the time of diagnosis of AKI was 7.9 ± 8.9 days. Hospital length of stay was longer in patients with AKI (p < 0.01), The risk for intensive care unit (ICU) admission and mortality were also higher (odds ratio [OR], 2.43 [95% confidence intervals (CI), 1.24 to 4.75)p < 0.01 and OR, 26.2 [95% CI, 8.8 to 104, P < 0.01). In a multivariate analysis, sepsis (OR, 3.64 [95% CI, 1.30 to 10.16] p = 0.013), dehydration (OR, 14.4 [95% CI, 4.49 to 46.19), baseline glomerular filtration (OR, 0.96 [95% CI, 0.94-0.98), contrast medium exposure (OR, 4.33 [95% CI, 1.60 to 11.66), recent exposure to Nonsteroidal Anti-inflammatory Drugs (OR 3.23 [95% CI, 1.22 to 8.52 (p = 0.02)] and Charlson comorbidity index (OR, 1.23 [95% CI, 1.05 to 1.43 (p < 0.01) were independent risk factors for Non-ICU HA-AKI. Conclusions: Non-ICU HA-AKI is associated with a longer hospital stay and higher risk of ICU admission and mortality. Most risk factors are potentially preventable.
author	González G.,Camilo A. Hurtado,Maite Contreras,Kateir García,Paola K. Rodríguez,Patricia Accini,Melisa Acuña,Paola Vera,Luis A.
author_facet	González G.,Camilo A. Hurtado,Maite Contreras,Kateir García,Paola K. Rodríguez,Patricia Accini,Melisa Acuña,Paola Vera,Luis A.
author_sort	González G.,Camilo A.
title	Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
title_short	Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
title_full	Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
title_fullStr	Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
title_full_unstemmed	Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
title_sort	lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018001201390
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Lesión renal aguda adquirida en el hospital: factores de riesgo y desenlaces clínicos

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