Incidence and outcomes of acute kidney injury among patients attending intensive care unit in China

Background: Despite vigorous and substantial measures to combat acute kidney injury (AKI) in intensive care unit (ICU), incidence and mortality of AKI is steadily increasing over time that requires more efforts needed to understand disease condition and course. Current study was aimed to determine incidence and outcomes of patients attending ICU in China. Methodology: Data from patients attending ICU during March 2014 to August 2014 were prospectively collected. AKI was stratified according to AKIN classification system. Patients with and without AKI were compared by appropriate statistical methods. Logistic regressions were used to determine predictors of AKI, longer ICU stay and mortality. Results: Incidence of AKI was 47.1% (769/1633) in total cohort including AKIN-I (8.7%), AKIN-II (15.3%) and AKIN-III (23.1%). Old age (OR 3.4), diabetes (OR 2.8), high SOFA/APACHE II scores (OR 2.2/4.1), sepsis (OR 9.4) and vasopressors (OR 6.2) were significant predictors of AKI. AKIN-III (OR 7.4), multiple organ dysfunctions (OR 3.8), RRT (OR 5.5) and mechanical ventilation (OR 2.7) were strongly associated with longer ICU stay. ICU mortality in our study was 27.4%. Elderly patients (OR 3.3) with AKIN-III (OR 5.6) having high SOFA score (OR 2.5) requiring RRT (OR 7.1) and mechanical ventilation (OR 9.2) had higher odds of death in our study. Conclusions: AKI imposes substantial burden to the health care system and patients in terms of morbidity, mortality and cost of care (hospital stay). Identification of high risk patients and adequate measures in timely manners may go in long run to combat AKI in ICU.