Author/Authors :
Safari ، Saeed - Shahid Beheshti University Of Medical Sciences , Hashemi ، Behrouz - Shahid Beheshti University Of Medical Sciences , Forouzanfar ، Mohammad Mehdi - Shahid Beheshti University Of Medical Sciences , Shahhoseini ، Mehrnoush - Shahid Beheshti University Of Medical Sciences , Heidari ، Meysam - Shahid Beheshti University Of Medical Sciences
Abstract :
Introduction: Elimination of preventable deaths due to acute kidney injury (AKI) in lowincome countries by 2025 is an important healthcare goal at the international level. The present study was designed with the aim of evaluating the prevalence and outcome of AKI in patients presenting to emergency department.Methods: The present crosssectional, retrospective study was performed on patients that presented to the emergency departments of 3 major teaching hospitals, Tehran, Iran, between 2005 and 2015 and were diagnosed with AKI. Patient selection was done using consecutive sampling and required data for this study was extracted by referring to the medical profiles of the patients and filling out a checklist designed for the study.Results: 770 AKI patients with the mean age of 62.72 ± 19.79 (1 – 99) years were evaluation (59.1% male). 690 (89.61%) cases of AKI causes were prerenal or renal. Among the prerenal causes, 74 (73.3%) cases were due to different types of shock (p lt; 0.001). The most common etiologic causes of AKI in prerenal group were hypotension (57.3%) and renal vascular insufficiency (31.6%). In addition, regarding the renal types, rhabdomyolysis (35.0%), medication (17.5%) and chemotherapy (15.3%) and in postrenal types, kidney stone (34.5%) were the most common etiologic causes. 327 (42.5%) patients needed dialysis and 169 (21.9%) patients died. Sex (p = 0.001), age over 60 years (p = 0.001), blood urea nitrogen level (p lt; 0.001), hyperkalemia (p lt; 0.001), metabolic acidosis (p lt; 0.001), cause of failure (p = 0.001), and type of failure (p = 0.009) were independent risk factors of mortality.Conclusion: The total prevalence of AKI in emergency department was 315 for each 1000000 population and preventable mortality rate due to AKI was estimated to be 28.2 cases in each 1000000 population. The most important preventable AKI causes in the prerenal group included shock, sepsis, and dehydration; in the renal group they included rhabdomyolysis and intoxication; and stones in the postrenal group.
Keywords :
Acute kidney injury , outcome assessment (health care) , prevalence , epidemiology , renal insufficiency
