Abstract

Background: Acute kidney injury (AKI) complicates more than 7% of all in-hospital patients. The aim of this study is to investigate the differences in community, hospital and intensive care unit-acquired AKI in patients undergoing nephrology consultation in a tertiary hospital in a developing country. Methods: An observational cohort study of all patients with AKI admitted to the General Hospital of Fortaleza, Brazil was conducted. RIFLE criteria were used to classify the patients and to assess their association with death. Univariate and multivariate analyses were performed to investigate the factors associated with death. Results: Of 491 AKI patients undergoing nephrology consultation, the mean age was 55.2 ± 22.9 years. Community-acquired AKI was observed in 55% of cases, general ward-acquired in 29% and ICU-acquired in 15.3%. Late Nephrology consultation was observed, and the great majority of patients had “Failure” classification (90%) according to RIFLE criteria. Intermittent hemodialysis was required in 68% of cases. The overall in-hospital mortality was 23%. The in-hospital mortality was higher in ICU-acquired AKI (33.6%). Community acquired AKI had a higher mortality than general ward-acquired AKI (23% vs. 11.6%, p = 0.001). Risk factors for death were infection (OR = 2.0, p = 0.003), neoplasms (OR = 1.89, p = 0.042), community acquired-AKI (OR = 1.27, p = 0.003), ICU acquired-AKI (OR = 2.76, p < 0.0001) and need for renal replacement therapy (OR = 2.64, p < 0.001). Conclusions: AKI is a frequent and frequently fatal condition. Mortality was higher in community and ICU-acquired than hospital ward-acquired AKI.

Author Details

Authors

• Elizabeth F. Daher¹,²
• Geraldo B. Silva Junior²,³
• Silvia Q. Santos¹
• Carla Camila R. Bezerra¹
• Elton J.B. Diniz¹
• Rafael S.A. Lima⁴
• Célio A. Babosa¹
• Antonio Augusto C. Guimarães¹
• Rosa M.S. Mota⁵
• Krasnalhia Lívia S. Abreu²
• Alexandre B. Libório¹,³

Departments

• ¹ Division of Nephrology, General Hospital of Fortaleza,
• ² Department of Internal Medicine, School of Medicine, Federal University of Ceará,
• ³ School of Medicine, University of Fortaleza. Fortaleza, Ceará,
• ⁴ Division of Nephrology, University of São Paulo, Ribeirão Preto, São Paulo,
• ⁵ Department of Statistics, Center of Science, Federal University of Ceará. Fortaleza, Ceará, Brazil

Address

Dr. Alexandre Braga Libório and Elizabeth Daher
Rua Vicente Linhares, nº 1198.
CEP 60135-270, Fortaleza, CE, Brazil
Email: [email protected]

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