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 inMedwave Vol. 17; no. 2; p. e6879
Main Authors Linares-Linares, Mariela Alejandra, Figueroa-Tarrillo, Jorge Arturo, Cerna Viacava, Renato, Carreazo, Nilton Yhuri, Valdivia-Vega, Renzo P
Format Journal Article
LanguageSpanish
English
Published Chile 06.03.2017
Subjects
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
risk factors
acute kidney injury
hospital mortality
renal dialysis
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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.
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
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  givenname: Mariela Alejandra
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  fullname: Linares-Linares, Mariela Alejandra
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  organization: Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú. Address: Batallón Tarma 428, Santiago de Surco, Lima, Perú. Email: malili0301@hotmail.com
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  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
URI https://www.ncbi.nlm.nih.gov/pubmed/28338650
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