Mortality and outcomes of acute kidney injury in intensive care unit

Acute kidney injury is known to be one of the common diseases who have increase number of admitting to ICU, having a variety of outcomes associated with comorbidities, risk factors and blood tests that interfere with the severity of the disease. We tried to evaluate and determine whether creatinine does play an impact role by assessing AKI patients outcomes and determine the prognosis of AKI patients who require dialysis .The research instrument we used was based on (creatinine, BUN, GFR, risk factors and comorbidities) of admitted patients during 2 consecutive years 2014 and 2015. Our objectives was to classify AKI patient into 2 stages according their creatinine values (<2,7 mg/dl and > or equal to 2,7 mg/dl), to asses AKI-associated risk factor and to determine AKI-interferes with comorbidities, as well as to determine the prognosis for patients who required dialysis in their treatment. We detailed the values from inpatient by a retrospective study containing of (n=30) in LSMU Kauno Klinikos between dates 2014 and 2015, given blood tests where analyzed, correlation between all 3 (creatinine, BUN and GFR) was assessed, frequency of comorbidities was determined, staging of AKI was done according to given creatinine values, comorbidities in AKI and CKI was calculated and explained, patients comorbidities was shown and staged according creatinine levels (< 2,7 mg/dl and >or equal from 2,7 mg/dl) and last but not least, the frequency of risk factors for patients with kidney diseases and classifying them into AKI and CKD furthermore according there creatinine levels was assessed. Results showed: an age of (64,79 +/- 18) for AKI and (66,55 +/- 22,5) for CKI. The deference in blood parameters in (2014/2015) was not significant. The decrease in creatinine strongly affect GFR rate, whereas correlation between creatinine and GFR was not statistically significant, but an increase in creatinine levels have influence on increasing BUN levels, this highlight the fact that creatinine value affect GFR ad BUN rate. The highest comorbidities frequency was other diseases including infectious disease and sepsis (40%), kidney disorders (16.7%) and lung involvement (13.3%), which in turn clarify that development of these comorbidities have influence on worse outcome for patients. Staging according creatinine values where (36.7 %) for (< 2,7mg/dl) and (63,3 %) for (>or equal to 2,7mg/dl). Patients with chronic kidney injury required more dialysis than patients with acute kidney injury, as well as they had an increase levels in their creatinine levels and lower levels in GFR rate, worsening the chronic phase. Comorbidities in patients with acute and chronic kidney injury demonstrate that AKI had kidney and liver disorders, cardiovascular diseases and lung manifestations more frequent than CKI. Creatinine values were higher in patients who had more comorbidities, this sum up the concept of developing a comorbidities can worse the phase of injury. The most frequent risk factors in patients with kidney injury was hypertension (70%), which emphasize for us that increase blood pressure has bad influence on kidney injury. Patients with chronic kidney injury had hyperparathyroidism as risk factor more frequent than AKI patients and it was significant (P=0,047), whereas AKI patients were prone to have DM II and hypertensive cardiomyopathy more frequently than CKI patients. Obese patients didn’t had elevation in their creatinine value significantly (P = 0.03) opposing other risk factors, which clarify that a high body mass index doesn’t affect severity of the disease.

Uminis inkstu pakenkimas yra viena dazniausiu inkstu ligu kuri reikalauja prieziuros intensyvios terapijos skyriuje, yra susijusi su daug gretutiniu ligu, rizikos faktoriu buvimas ir kraujo tyrimu atsakymai lemia ligos sunkuma. We tried to evaluate and determine whether creatinine does play an impact role by assessing AKI patients outcomes and determine the prognosis of AKI patients who require dialysis .The research instrument we used was based on (creatinine, BUN, GFR, risk factors and comorbidities) of admitted patients during 2 consecutive years 2014 and 2015. Our objectives was to classify AKI patient into 2 stages according their creatinine values (<2,7 mg/dl and > or equal to 2,7 mg/dl), to asses AKI-associated risk factor and to determine AKI-interferes with comorbidities, as well as to determine the prognosis for patients who required dialysis in their treatment. We detailed the values from inpatient by a retrospective study containing of (n=30) in LSMU Kauno Klinikos between dates 2014 and 2015, given blood tests where analyzed, correlation between all 3 (creatinine, BUN and GFR) was assessed, frequency of comorbidities was determined, staging of AKI was done according to given creatinine values, comorbidities in AKI and CKI was calculated and explained, patients comorbidities was shown and staged according creatinine levels (< 2,7 mg/dl and >or equal from 2,7 mg/dl) and last but not least, the frequency of risk factors for patients with kidney diseases and classifying them into AKI and CKD furthermore according there creatinine levels was assessed. Results showed: an age of (64,79 +/- 18) for AKI and (66,55 +/- 22,5) for CKI. The deference in blood parameters in (2014/2015) was not significant. The decrease in creatinine strongly affect GFR rate, whereas correlation between creatinine and GFR was not statistically significant, but an increase in creatinine levels have influence on increasing BUN levels, this highlight the fact that creatinine value affect GFR ad BUN rate. The highest comorbidities frequency was other diseases including infectious disease and sepsis (40%), kidney disorders (16.7%) and lung involvement (13.3%), which in turn clarify that development of these comorbidities have influence on worse outcome for patients. Staging according creatinine values where (36.7 %) for (< 2,7mg/dl) and (63,3 %) for (>or equal to 2,7mg/dl). Patients with chronic kidney injury required more dialysis than patients with acute kidney injury, as well as they had an increase levels in their creatinine levels and lower levels in GFR rate, worsening the chronic phase. Comorbidities in patients with acute and chronic kidney injury demonstrate that AKI had kidney and liver disorders, cardiovascular diseases and lung manifestations more frequent than CKI. Creatinine values were higher in patients who had more comorbidities, this sum up the concept of developing a comorbidities can worse the phase of injury. The most frequent risk factors in patients with kidney injury was hypertension (70%), which emphasize for us that increase blood pressure has bad influence on kidney injury. Patients with chronic kidney injury had hyperparathyroidism as risk factor more frequent than AKI patients and it was significant (P=0,047), whereas AKI patients were prone to have DM II and hypertensive cardiomyopathy more frequently than CKI patients. Obese patients didn’t had elevation in their creatinine value significantly (P = 0.03) opposing other risk factors, which clarify that a high body mass index doesn’t affect severity of the disease.