Clinical features and risk factors of acute kidney injury in hospitalized patients

Objective To determine the incidence,etiology,distribution of department and related risk factors of acute kidney injury(AKI)among hospitalized patients so as to provide help for the prevention and improvement of prognosis of AKI.Methods A total of 31 026 patients admitted to our hospital from January 1st2011 to December 31 st 2011were involved in this study.Those patients whose diagnosis was consistent with the2012 kidney disease:improving global outcomes(KDIGO)for AKI were picked out to analyze the prevalence and risk factors of AKI.Clinical outcome was classified as survival,death and abandon.The renal outcome included complete recovery(serum creatinine was less than 1.5fold of baseline while discharging),partial recovery(serum creatinine was decreased while discharging but more than 1.5fold of baseline,no need of dialysis),and no recovery(serum creatinine was the peak or dialysis was essential while discharging or death).ResultsEventually,564 patients were diagnosed as AKI.The overall incidence of AKI was 1.8%,of which AKI stage one,two and three accounted for 40.6%,28.2%,and 31.2%,respectively.The department in which AKI occurred most frequently was the Department of Nephrology with 22.0% of prevalence,followed by the Department of Cardiology(12.2%),the Department of Urology(10.6%),ICU(10.1%),and the Department of Neurosurgery(8.3%)and the Department of Liver Transplantation(6.4%).In the aspect of etiology,the major risk factors of AKI were surgery(39.5%),infection(19.5%)and renal factors(12.2%).Of the AKI patients,438(77.7%)were improved before discharge,69(12.2%)died,and 57(10.1%)abandoned the treatment.The Logistic regression analysis showed that age(OR=1.84,95%CI:1.05-3.65)and AKI stage(OR=3.21,95%CI:1.66-6.20)were positively correlated with mortality in AKI patients(both P0.05).Conclusion AKI is prevalent in hospitalized patients and has a high mortality.Older age and severe AKI are related to the bad outcomes of AKI.