Risk factors and prognosis of acute kidney injury in adult hospitalized patients: a two-year outcome

AIM: Acute kidney injury (AKI) is becoming increasingly common in hospitalized patients. A few studies have defined epidemiological data concerning hospital-acquired AKI. The aim of this study was to determine the incidence and the risk factors of hospital-acquired AKI and its treatment and prevention.

METHODS: A dataset of 123,105 adults who were treated in the hospital from January 2010 to December 2011, excluding patients with chronic kidney disease (CKD) and community-acquired AKI patients, was evaluated. Clinical data of blood urea nitrogen (BUN) and serum creatinine (SCr) were collected and analyzed. AKI was defined and classified according to the Acute Kidney Injury Network (AKIN). Data were compared among patients with hospital-acquired and non-hospital-acquired AKI.

RESULTS: Among a cohort of 123,105 hospitalized adult patients, 174 patients were identified with hospital-acquired AKI. The number of cases aged 18-39, 40-59, 60-79 and ≥80 years was, respectively, 15 (8.6%), 39 (22.4%), 82 (47.1%), and 38 (21.8%); the 60-79 years age group had the highest number. Univariate analysis showed that the unfavorable prognosis was correlated with >60 years of age, coronary heart disease, diabetes, hypotension, unconsciousness, mechanical ventilation, injuries and multiple organ dysfunction syndrome (MODS). Multivariate logistic regression analysis demonstrated that the coronary heart disease, diabetes, hypotension, mechanical ventilation and MODS were independent unfavorable prognostic factors for hospital-acquired AKI.

CONCLUSION: Prerenal and renal factors are the major causes of the development of hospital-acquired AKI. Thus, focusing on the potential risk factors of hospital-acquired AKI may prove to be beneficial to the prognosis of patients.