Risk factors of acute kidney injury and dialysis among patients attending intensive care units in China

Acute Kidney Injury (AKI) in intensive care unit (ICU) is highly morbid and fatal conditions and patients who received dialysis portend even worse outcomes. Current prospective observational study was aimed to evaluate the risk factors associated with AKI and dialysis among patients attending ICU during predefined period of six months. Predisposing factors were evaluated by using logistic regression. Out of total 1544 patients, 748 (48.4%) had AKI while 244 (16%) patients received renal replacement therapy (RRT). Among patients receiving dialysis, 231 were having AKI. Old age, diabetes mellitus, mechanical ventilation, use of vasopressors, sepsis, SOFA score > 9 and high APACHE-II score were significant risk factors of AKI in current study. AKI patients with old age, female gender, mechanical ventilation, use of vasopressors, sepsis, score > 9 and high APACHE-II were found to be at high risk of receiving dialysis in study cohort. ROC curve analysis demonstrated excellent prediction accuracy of regression model for AKI (AUC: 0.845, P< 0.001) and dialysis (AUC: 0.785, P< 0.001). Moreover, AKI and dialysis use was associated with higher mortality and prolonged hospital stay present study. Overall mortality in current study was 30.1% while mortality among AKI patients receiving RRT was 42.5%. A substantial number of patients attending ICU had AKI. Dialysis was initiated among significant proportion of study participants and most of them had AKI. High risks patients should be managed aggressively in the first instance. Early identification may cause a dramatic decrease in mortality and morbidity could be expected in these high-risk patients.