Clinical features and prognostic analysis of AKI in the internal medicine departments

XUE Xian; TANG Xiao-jing; ZHANG Di; SHEN Ai-wen; MEI Chang-lin

doi:10.3969/j.issn.1671-2390.2018.03.002

Journal of Clinical Nephrology > 2018 > 18(3): 135-140. > DOI: 10.3969/j.issn.1671-2390.2018.03.002

XUE Xian, TANG Xiao-jing, ZHANG Di, SHEN Ai-wen, MEI Chang-lin. Clinical features and prognostic analysis of AKI in the internal medicine departments[J]. Journal of Clinical Nephrology, 2018, 18(3): 135-140. DOI: 10.3969/j.issn.1671-2390.2018.03.002

Citation:

PDF (634 KB)

Clinical features and prognostic analysis of AKI in the internal medicine departments

Kidney Institute, Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

More Information

Received Date: October 17, 2017
Rev Recd Date: February 12, 2018
Available Online: May 11, 2023
Published Date: March 27, 2018

Graphical Abstract

Abstract

Abstract

Objective To explore the clinical features of patients with acute kidney injury (AKI) in the internal medicine departments.Methods The kidney function indexes of the internal medicine patients were collected in Shanghai Changzheng Hospital from 2011 to 2012. According to the AKI diagnostic criteria of KDIGO in 2012, we screened out the AKI patients who met the criteria. By retrospectively studying their clinical data, we analyzed and summarized their clinical characteristics and the factors affecting the prognosis.Results From January 2011 to December 2012, there were a total of 33 332 cases of internal medicine patients in our hospital and 245 of them met the criteria of AKI. The incidence of AKI was 0.74% in internal medicine departments while the detection rate of AKI was 35.92%. The proportions of patients with AKI stage 1 to 3 were 42.45%, 20.41% and 37.14%, respectively. Among all the internal medicine departments, patients in the department of nephrology accounted for 33.47%, followed by the department of cardiology (20.00%), gastroenterology (11.84%) and infectious disease (10.61%). The incidence of AKI from high to low was infection disease department (1.70%), nephrology department (1.37%), and cardiology department (1.11%). Of all the hospitalized patients with AKI, 71.84% discharged with a better health condition and the kidney function discovered in only 34.69% of the discharged patients; 28.16% died or gave up treatment. The most common departments with high fatality rate were the department of infectious disease (21.74%), gastroenterology and cardiology. Infection was the main cause of the AKI in internal medicine departments. Logistic regression analysis showed that higher AKI stage, more AKI risk factors, combination with liver disease or tumor were risk factors for death and giving up treatment, while chronic kidney disease was the protective factor.Conclusions AKI is common in internal medicine system, with a high mortality rate and a higher recognition rate than perioperative AKI. Except for the department of nephrology, cardiology, departments of infectious disease and gastroenterology have heavy burden of AKI. The advanced stage of AKI, more risk factors, and comorbidities such as liver disease or tumor were associated with poor prognosis.
- Internal medicine,
- Acute kidney injury,
- Incidence,
- Recognition rate

FullText(HTML)

References (18)

References

[1]	Hsu RK, McCulloch CE, Dudley RA, et al. Temporal changes in incidence of dialysis-requiring AKI[J]. J Am Soc Nephrol, 2013, 24(1):37-42.
[2]	Zappitelli M, Moffett BS, Hyder A, et al. Acute kidney injury in non-critically ill children treated with aminoglycoside antibiotics in a tertiary healthcare centre:a retrospective cohort study[J]. Nephrol Dial Transplant, 2011, 26(1):144-150.
[3]	Bellomo R, Ronco C, Kellum JA, et al. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs:the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group[J]. Crit Care, 2004, 8(4):R204-R212.
[4]	Thakar CV, Christianson A, Freyberg R, et al. Incidence and outcomes of acute kidney injury in intensive care units:a Veterans Administration study[J]. Critl Care Med, 2009, 37(9):2552-2558.
[5]	Uchino S, Kellum JA, Bellomo R, et al. Acute renal failure in critically ill patients:a multinational, multicenter study[J]. JAMA, 2005, 294(7):813-818.
[6]	Tang X, Chen D, Yu S, et al. Acute kidney injury burden in differentclinical units:Data from nationwide survey in China[J]. PLoS One, 2017, 12(2):e0171202.
[7]	Yang L, Xing G, Wang L, et al. Acute kidney injury in China:a cross-sectional survey[J]. Lancet, 2015, 386(10002):1465-1471.
[8]	张帝, 汤晓静, 申嫒文, 等. 围手术期急性肾损伤临床特征及预后180例分析[J]. 中国实用内科杂志, 2017, 37(1):54-58.
[9]	MacLeod A. NCEPOD report on acute kidney injury-must do better[J]. Lancet, 2009, 374(9699):1405-1406.
[10]	Alobaidi R, Basu RK, Goldstein SL, et al. Sepsis-Associated Acute Kidney Injury[J]. Semi Nephrol, 2015, 35(1):2-11.
[11]	Matejovic M, Chvojka J, Radej J, et al. Sepsis and acute kidney injury are bidirectional[J]. Contrib Nephrol, 2011, 174:78-88.
[12]	Andreucci M, Faga T, Pisani A, et al. Acute kidney injury by radiographic contrast media:pathogenesis and prevention[J]. Biomed Res Int, 2014, 2014:362725.
[13]	Andreucci M, Solomon R, Tasanarong A. Side effects of radiographic contrast media:pathogenesis, risk factors, and prevention[J]. Biomed Res Int, 2014, 2014:741018.
[14]	Cerda J, Cerda M, Kilcullen P, et al. In severe acute kidney injury, a higher serum creatinine is paradoxically associated with better patient survival[J]. Nephrol Dial Transplant, 2007, 22(10):2781-2784.
[15]	Pan HC, Wu PC, Wu VC, et al. A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI)-patients with and without preexisting chronic kidney disease have different prognoses[J]. Medicine (Baltimore), 2016, 95(39):e4987.
[16]	Khosla N, Soroko SB, Chertow GM, et al. Preexisting chronic kidney disease:a potential for improved outcomes from acute kidney injury[J]. Clin J Am Soc Nephrol, 2009, 4(12):1914-1919.
[17]	Mehta RL, McDonald B, Gabbai F, et al. Nephrology consultation in acute renal failure:does timing matter?[J]. Am J Med, 2002, 113(6):456-461.
[18]	Ahmed W, Memon JI, Rehmani R, et al. Outcome of patients with acute kidney injury in severe sepsis and septic shock treated with early goal-directed therapy in an intensive care unit[J]. Saudi J Kidney Dis Transpl, 2014, 25(3):544-551.

[1]	Yi Yan-min, Cao Hu-nan, Lu Lin, Lu Chun-hong, Zhang Wen-jin, Kong Ling. Systematic review and Meta-analysis of intradialytic hypotension incidence in Chinese maintenance hemodialysis patients[J]. Journal of Clinical Nephrology, 2024, 24(10): 817-826. DOI: 10.3969/j.issn.1671-2390.2024.10.004
[2]	Wan Jing-fang, Lin Jing, Zhang Wei-wei, Xiang Yang, Chen Ke-hong. Impact of blood flow rate on mortality in hemodialysis patients[J]. Journal of Clinical Nephrology, 2023, 23(3): 185-190. DOI: 10.3969/j.issn.1671-2390.2023.03.002
[3]	Kuang Qian-hui-ning, Gao Chun-lin, Xia Zheng-kun. Comparison of using glomerular filtration rate estimation equations in children with chronic kidney disease[J]. Journal of Clinical Nephrology, 2023, 23(2): 98-104. DOI: 10.3969/j.issn.1671-2390.2023.02.003
[4]	Xu Li-bin, Wang Ya-jie, Han Yun-biao, Zhao Yi-wen, Zhu Li-ge, Liu Guo-ping, Wang Dan, Yu Lei. Clinical hazards of acute kidney injury in hospitalized population in Inner Mongolia Autonomous Region[J]. Journal of Clinical Nephrology, 2022, 22(12): 987-992. DOI: 10.3969/j.issn.1671-2390.2022.12.004
[5]	Liu Mei-ling, Zhang Jiong, Wang Jin-quan. Research advances of minimal change disease combined with acute kidney injury[J]. Journal of Clinical Nephrology, 2021, 21(10): 855-859. DOI: 10.3969/j.issn.1671-2390.2021.10.010
[6]	HE Xue-qin, ZHOU Xue-li, JIANG Jing, QIN Min, PU Li, ZHONG Hui. A study on standard level compliance rate of parathyroid hormone and its correlation with age in elderly patients with peritoneal dialysis[J]. Journal of Clinical Nephrology, 2020, 20(2): 142-146. DOI: 10.3969/j.issn.1671-2390.2020.02.010
[7]	FU Shuai, LI Xiao-ning. The research development of formulas for calculating glomerular filtration rate: from Cockcroft-Gault formula to full age spectrum (FAS)formula[J]. Journal of Clinical Nephrology, 2020, 20(1): 73-77. DOI: 10.3969/j.issn.1671-2390.2020.01.014
[8]	LIU Hui-lan, LI Xiao-ning, FU Shuai, HU Yu-gang, WAN Jing. Predictive value of serum cystatin C for morbidity and prognosis of acute kidney injury in patients with acute coronary artery syndrome[J]. Journal of Clinical Nephrology, 2019, 19(7): 482-487. DOI: 10.3969/j.issn.1671-2390.2019.07.003
[9]	WANG Rui, SHUI Hua, HU Hong-tao, HU Yu-gang, GAO Yue, HU Shuang. Incidence and mortality of acute kidney injury after cerebral hemorrhage in neurology care unit[J]. Journal of Clinical Nephrology, 2018, 18(10): 624-629. DOI: 10.3969/j.issn.1671-2390.2018.10.008
[10]	WANG Lei, WU Yang, SONG Xiao-hong, WU Wei-cong, WEI Hong-lan, DONG Jun-wu. Effect of calcium dobesilate administration on the decline rate of glomerular filtration rate in patients with diabetic nephropathy[J]. Journal of Clinical Nephrology, 2017, 17(12): 731-734. DOI: 10.3969/j.issn.1671-2390.2017.12.005

Cited By

Get Citation

PDF

XML

Article views (400) PDF downloads (275)

Turn off MathJax

Article Contents

Abstract

References

Clinical features and prognostic analysis of AKI in the internal medicine departments

Abstract

References

Related Articles

Catalog

Clinical features and prognostic analysis of AKI in the internal medicine departments

Abstract

References

Related Articles

Catalog

Export File

Citation

Format

Content