A SINGLE-CENTER STUDY EVALUATING THE PREVALENCE, RISK FACTORS, AND CONSEQUENCES OF ACUTE KIDNEY INJURY IN THE INTENSIVE CARE UNIT

R PERVAIZ; MA QAYYUM; SA KHALID; T HAFEEZ; MU MUNAWAR; HMH ARIF; H KANDEEL; WG ELMASRY; S RAZA

doi:10.54112/pjicm.v4i01.22

Authors

R PERVAIZ Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan.
MA QAYYUM Department of Nephrology, Division of Medicine, Bahria International Hospital, Lahore, Pakistan
SA KHALID Department of Nephrology, Rashid Latif Khan University, Lahore, Pakistan
T HAFEEZ Department of Nephrology, Division of Medicine, Bahria International Hospital, Lahore, Pakistan
MU MUNAWAR Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan.
HMH ARIF Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan.
H KANDEEL Department of Critical Care Medicine, Hatta Hospital, Dubai Health, UAE.
WG ELMASRY Medical Intensive Care Unit, Rashid Hospital, Dubai Health, Dubai, UAE.
S RAZA Department of Internal and Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan.

DOI:

https://doi.org/10.54112/pjicm.v4i01.22

Keywords:

Acute Kidney Injury, Critical Illness, Intensive Care Units, Mortality, Risk Factors

Abstract

Background: Acute kidney injury (AKI) is a significant complication in critically ill patients in intensive care units (ICUs), impacting morbidity, mortality, and overall patient outcomes. Objectives: To assess the frequency, risk factors, and implications of AKI among individuals admitted to the medical ICU at Bahria International Hospital between 2021 and 2022. Study Design: This study utilized a retrospective design. Setting: The study was conducted at Bahria International Hospital's medical ICU. Duration of Study: Data were collected between September 2022 and September 2023. Material and Methods: AKI frequency and risk factors were assessed using the Acute Kidney Injury Network (AKIN) criteria for staging. Risk factors such as age, hypertension, ACEI/ARB usage, and severity of underlying illnesses (measured by APACHE II scores) were analyzed. Multivariate analysis was performed to identify independent predictors of AKI occurrence. Results: The study found that 32.7% of ICU patients experienced AKI, primarily categorized as stage 1 AKI (60.12%). Advanced age, hypertension, ACEI/ARB usage, and higher APACHE II scores were significant risk factors for AKI development. Multivariate analysis identified age (HR 1.3, 95% CI 1.2-1.5, P = 0.01) and APACHE II score (HR 1.6, 95% CI 1.3-1.8, P = 0.02) as independent predictors of AKI occurrence. Conclusion: The incidence of AKI among ICU patients is substantial and associated with increased mortality and morbidity. Early identification and management of modifiable risk factors are crucial for mitigating AKI-related complications and improving patient outcomes. Proactive measures in critical care settings are necessary to reduce AKI burden and enhance patient care.

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