Risk factors for the prognosis of acute kidney injury under the Acute Kidney Injury Network definition: a retrospective, multicenter study in critically ill patients

Abstract

Aim: Despite significant advances in medical management and therapeutics, acute kidney injury (AKI) is still a common and serious complication with high morbidity and mortality in hospitalized patients, especially in patients admitted to the intensive care unit (ICU). The primary purpose of this study is to apply the definition proposed by the Acute Kidney Injury Network (AKIN) to investigate the incidence, 28-day mortality and risk factors for the prognosis of AKI in ICU.

Methods: In this retrospective study, data from a cohort of 4642 patients admitted to five ICUs were analyzed. Univariate and multivariate analyses were performed to investigate the risk factors for prognosis of AKI.

Results: A total of 1036 patients were enrolled. AKI occurred in 353 of them (34.1%) under the AKIN criteria and the mortality was 54.4%. Multivariable analysis showed that variables related to the prognosis of AKI were: four or more (≥4) organ failed systems (odds ratio (OR) = 25.612), AKI III (OR = 14.441), AKI II (OR = 4.491), mechanical ventilation (OR = 7.201), sepsis (OR = 4.552), severe acute pancreatitis (OR = 3.299), base serum creatinine (OR = 1.004) and the length of stay in ICU (OR = 1.050).

Conclusions: For critically ill patient, the ICU mortality of AKI was correlated with various independent risk factors, especially AKI II, AKI III, severe acute pancreatitis and multiple organ failed systems.