Risk factors associated to hospital mortality in patients with acute kidney injury on hemodialysis
The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients. To identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis...
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Published in | Medwave Vol. 17; no. 2; p. e6879 |
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Abstract | The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients.
To identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis patients.
This is a retrospective cohort of patients with acute kidney injury in hemodialysis of Hospital Nacional Edgardo Rebagliati Martins gathered between January 2013 and December 2015. The sample size was 154 patients which allowed a power of 80% and a CI of 95%. ICD-10 codes were used to identify medical records of patients with acute kidney injury (N.17) and hemodialysis (Z.49). The independent variable was oliguria, and the primary outcome was hospital mortality. Poisson regression was used for multivariate analysis.
We identified a total of 285 patients; 212 medical records were analyzed and 44 were excluded. Out of the 168 medical records, 129 belonged to living patients and 39 to deceased ones. The overall mortality incidence was 17.2%. The principal etiologies of acute kidney injury while in hemodialysis were sepsis (39.2%), and severe dehydration (10.8%). In the adjusted model, the risk factors associated to hospital mortality of acute kidney injury while in hemodialysis were elevated serum lactate (RR 1.09), elevated serum potassium (RR 0.93), and mean arterial pressure (RR 0.97).
Lactate is an objective parameter that can predict prognosis and contributes to a better management of acute kidney injury in hemodialysis patients. |
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AbstractList | INTRODUCTIONThe worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients. OBJECTIVESTo identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis patients. METHODSThis is a retrospective cohort of patients with acute kidney injury in hemodialysis of Hospital Nacional Edgardo Rebagliati Martins gathered between January 2013 and December 2015. The sample size was 154 patients which allowed a power of 80% and a CI of 95%. ICD-10 codes were used to identify medical records of patients with acute kidney injury (N.17) and hemodialysis (Z.49). The independent variable was oliguria, and the primary outcome was hospital mortality. Poisson regression was used for multivariate analysis. RESULTSWe identified a total of 285 patients; 212 medical records were analyzed and 44 were excluded. Out of the 168 medical records, 129 belonged to living patients and 39 to deceased ones. The overall mortality incidence was 17.2%. The principal etiologies of acute kidney injury while in hemodialysis were sepsis (39.2%), and severe dehydration (10.8%). In the adjusted model, the risk factors associated to hospital mortality of acute kidney injury while in hemodialysis were elevated serum lactate (RR 1.09), elevated serum potassium (RR 0.93), and mean arterial pressure (RR 0.97). CONCLUSIONSLactate is an objective parameter that can predict prognosis and contributes to a better management of acute kidney injury in hemodialysis patients. The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of acute kidney injury in hemodialysis patients. To identify risk factors associated to hospital mortality of acute kidney injury in hemodialysis patients. This is a retrospective cohort of patients with acute kidney injury in hemodialysis of Hospital Nacional Edgardo Rebagliati Martins gathered between January 2013 and December 2015. The sample size was 154 patients which allowed a power of 80% and a CI of 95%. ICD-10 codes were used to identify medical records of patients with acute kidney injury (N.17) and hemodialysis (Z.49). The independent variable was oliguria, and the primary outcome was hospital mortality. Poisson regression was used for multivariate analysis. We identified a total of 285 patients; 212 medical records were analyzed and 44 were excluded. Out of the 168 medical records, 129 belonged to living patients and 39 to deceased ones. The overall mortality incidence was 17.2%. The principal etiologies of acute kidney injury while in hemodialysis were sepsis (39.2%), and severe dehydration (10.8%). In the adjusted model, the risk factors associated to hospital mortality of acute kidney injury while in hemodialysis were elevated serum lactate (RR 1.09), elevated serum potassium (RR 0.93), and mean arterial pressure (RR 0.97). Lactate is an objective parameter that can predict prognosis and contributes to a better management of acute kidney injury in hemodialysis patients. |
Author | Linares-Linares, Mariela Alejandra Valdivia-Vega, Renzo P Figueroa-Tarrillo, Jorge Arturo Cerna Viacava, Renato Carreazo, Nilton Yhuri |
Author_xml | – sequence: 1 givenname: Mariela Alejandra surname: Linares-Linares fullname: Linares-Linares, Mariela Alejandra email: malili0301@hotmail.com organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú. Address: Batallón Tarma 428, Santiago de Surco, Lima, Perú. Email: malili0301@hotmail.com – sequence: 2 givenname: Jorge Arturo surname: Figueroa-Tarrillo fullname: Figueroa-Tarrillo, Jorge Arturo organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú – sequence: 3 givenname: Renato surname: Cerna Viacava fullname: Cerna Viacava, Renato organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú – sequence: 4 givenname: Nilton Yhuri surname: Carreazo fullname: Carreazo, Nilton Yhuri organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú; Servicio de Cuidados Intensivos, Hospital de Emergencias Pediátricas, Lima, Perú – sequence: 5 givenname: Renzo P surname: Valdivia-Vega fullname: Valdivia-Vega, Renzo P organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú; Unidad de Hemodiálisis, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú |
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Snippet | The worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about mortality of... INTRODUCTIONThe worldwide incidence of acute kidney injury is 18% and the overall hospital mortality can rise above 50%. In Peru, there are few series about... |
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SubjectTerms | Acute Kidney Injury - mortality Acute Kidney Injury - therapy Aged Arterial Pressure Cohort Studies Female Hospital Mortality Humans Lactic Acid - blood Male Middle Aged Multivariate Analysis Poisson Distribution Potassium - blood Prognosis Renal Dialysis Retrospective Studies Risk Factors |
Title | Risk factors associated to hospital mortality in patients with acute kidney injury on hemodialysis |
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