Epidemiology of Hospital-Acquired Acute Kidney Injury(HAAKI) in Medical Hospitalized Patients in Al-Diwanyia Teaching Hospital

Abstract

Background: Minimum elevation of serum creatinine,even within normal reference range are associated with worse outcome of the patients.

        Objective: The application of the most recent definition of AKI  proposed by the Acute                    Kidney Injury Network (AKIN),published in March 2012 to promote the earlier detection  of                HAAKI.             

        Patients&Method: Cross –sectional observational study conducted in the medical                                      ward in Al-Diwanyia Teaching Hospital for a period 9 months from 1st of January to 30 of                                 September 2013 . All adolescents & adults patients who fulfill the criteria of the study included.                   Data about demographics ,co-morbidities of patients & serial measurement of (S.Cr) were                             directly collected . The definition of AKI  according to  Kidney Disease: Improving                                          Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury -2012,based on AKIN               criteria.

Result:

Out of 522 patients included in the study( the mean age of them 59 ± 23) ,HAAKI (stage1)were recorded in 79 (15.13%) patients  , elderly patients aged ? 65  represent  50.63% of all cases of HAAKI(without significant gender variation). About 19 patients(24.05%) morbidities HAAKI due to intermingle co morbidities. The most 3 prevalent co morbidities were reported either independent or in association with other co morbidities in patients with HAAKI,1stone diabetes mellitus , 51 diabetic patients which represent  64.5% of total 79 patients with HAAKI  & 37.22% of total diabetic patients studied . The 2nd was sepsis which reported in about 37 patients (46.83%).About  36 patients (45.56%) had HAAKI due to nephrotoxic drugs which represent the 3rd more frequent co morbidities.

 Limitations: Single-medical ward study of limited period .Classification of the diseases according to conventional method.

Conclusions: Our results suggest that HAAKI is a common complication . Our efforts should be focused to prevent or minimize the risk factors of HAAKI (particularly in advanced age).