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Epidemiology of acute kidney injury in Canadian critical care units: a prospective cohort study.
Can J Anaesth. 2012 Oct; 59(10):934-42.CJ

Abstract

PURPOSE

We undertook this study to characterize the epidemiology of acute kidney injury (AKI) in Canadian critical care units. We aimed to identify predictors of mortality for patients diagnosed with AKI.

METHODS

We conducted a prospective cohort study of consecutive patients admitted to critical care units at five Canadian hospitals over a 30-day period. Each patient was followed until hospital discharge or for a maximum of 30 days. The serum creatinine criteria for the Acute Kidney Injury Network (AKIN-SCr) system were used to identify, classify, and characterize patients who developed AKI. We used multivariable logistic regression to predict 30-day mortality among patients with AKI.

RESULTS

We identified 603 patients, 161 (26.7%) of whom developed AKI. Compared to patients without AKI, those with AKI were more likely to die (29.2% vs 8.6%, P < 0.001). The risk of death increased with increasing AKIN-SCr stage (P < 0.001). In all, 19 patients (11.8% of those with AKI) commenced dialysis a median of one day (interquartile range, one to two days) after AKI diagnosis. At AKI diagnosis, the blood urea nitrogen (BUN) level (adjusted odds ratio [OR] 1.68, 95% confidence interval [CI] 1.01 to 2.79/10 mmol·L(-1)) and serum bicarbonate (adjusted OR 0.88, 95% CI 0.81 to 0.95/1 mmol·L(-1)) were associated with 30-day mortality and predicted death with an area under the receiver-operating characteristic curve of 0.79 (95% CI 0.71 to 0.86).

CONCLUSIONS

Acute kidney injury is a common complication of critical illness in Canada. The development of even the mildest stage of AKI is associated with a substantially higher risk of death. At AKI diagnosis, routine clinical data may be helpful for predicting adverse outcomes.

Authors+Show Affiliations

Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22843289

Citation

Odutayo, Ayodele, et al. "Epidemiology of Acute Kidney Injury in Canadian Critical Care Units: a Prospective Cohort Study." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 59, no. 10, 2012, pp. 934-42.
Odutayo A, Adhikari NK, Barton J, et al. Epidemiology of acute kidney injury in Canadian critical care units: a prospective cohort study. Can J Anaesth. 2012;59(10):934-42.
Odutayo, A., Adhikari, N. K., Barton, J., Burns, K. E., Friedrich, J. O., Klein, D., Lapinsky, S., Litwin, S., Meret, A., Moineddin, R., Richardson, B., Richardson, R., Zaltzman, A., Hladunewich, M., & Wald, R. (2012). Epidemiology of acute kidney injury in Canadian critical care units: a prospective cohort study. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 59(10), 934-42.
Odutayo A, et al. Epidemiology of Acute Kidney Injury in Canadian Critical Care Units: a Prospective Cohort Study. Can J Anaesth. 2012;59(10):934-42. PubMed PMID: 22843289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of acute kidney injury in Canadian critical care units: a prospective cohort study. AU - Odutayo,Ayodele, AU - Adhikari,Neill K J, AU - Barton,James, AU - Burns,Karen E A, AU - Friedrich,Jan O, AU - Klein,David, AU - Lapinsky,Stephen, AU - Litwin,Sasha, AU - Meret,Aleksander, AU - Moineddin,Rahim, AU - Richardson,Bonnie, AU - Richardson,Robert, AU - Zaltzman,Alina, AU - Hladunewich,Michelle, AU - Wald,Ron, Y1 - 2012/07/28/ PY - 2012/02/15/received PY - 2012/07/12/accepted PY - 2012/7/31/entrez PY - 2012/7/31/pubmed PY - 2013/2/14/medline SP - 934 EP - 42 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 59 IS - 10 N2 - PURPOSE: We undertook this study to characterize the epidemiology of acute kidney injury (AKI) in Canadian critical care units. We aimed to identify predictors of mortality for patients diagnosed with AKI. METHODS: We conducted a prospective cohort study of consecutive patients admitted to critical care units at five Canadian hospitals over a 30-day period. Each patient was followed until hospital discharge or for a maximum of 30 days. The serum creatinine criteria for the Acute Kidney Injury Network (AKIN-SCr) system were used to identify, classify, and characterize patients who developed AKI. We used multivariable logistic regression to predict 30-day mortality among patients with AKI. RESULTS: We identified 603 patients, 161 (26.7%) of whom developed AKI. Compared to patients without AKI, those with AKI were more likely to die (29.2% vs 8.6%, P < 0.001). The risk of death increased with increasing AKIN-SCr stage (P < 0.001). In all, 19 patients (11.8% of those with AKI) commenced dialysis a median of one day (interquartile range, one to two days) after AKI diagnosis. At AKI diagnosis, the blood urea nitrogen (BUN) level (adjusted odds ratio [OR] 1.68, 95% confidence interval [CI] 1.01 to 2.79/10 mmol·L(-1)) and serum bicarbonate (adjusted OR 0.88, 95% CI 0.81 to 0.95/1 mmol·L(-1)) were associated with 30-day mortality and predicted death with an area under the receiver-operating characteristic curve of 0.79 (95% CI 0.71 to 0.86). CONCLUSIONS: Acute kidney injury is a common complication of critical illness in Canada. The development of even the mildest stage of AKI is associated with a substantially higher risk of death. At AKI diagnosis, routine clinical data may be helpful for predicting adverse outcomes. SN - 1496-8975 UR - https://www.unboundmedicine.com/medline/citation/22843289/Epidemiology_of_acute_kidney_injury_in_Canadian_critical_care_units:_a_prospective_cohort_study_ L2 - https://doi.org/10.1007/s12630-012-9761-1 DB - PRIME DP - Unbound Medicine ER -