Epidemiology Of Acute Kidney Injury In Hospitalized Patients Of Inner Mongolia Autonomous Region

Acute kidney injury(AKI)refers to a clinical syndrome encompassing various etiologies and occurring in a variety of clinical settings.The classification of Kidney Disease:Improving Global Outcomes(KDIGO)is the recognized criteria and a rapid rise of creatinine is used as standard marker most widely.Based on the development time,the AKI is classified into community-acquired acute kidney injury(CA-AKI)and(hospital-acquired acute kidney injury,HA-AKI).The following epidemiological charateristics of AKI in the Inner Mongolia Autonomous Region have not been clear:(1)the ethetic difference between the Mongolian nationality and other nationalities;(2)stratification study by age subgroup has been conducted and the potential cut-off age with high risk for AKI has not clear;(3)stratification analysis by AKI categroy subgroup has not been well studied the epidemiological charateristics by AKI categories have not been well understood.(4)interaction between age and AKI categories has not been controlled when analysed the outcomes.Thus,we investiaged above issues respectively,using the dataset from two hospitals in the Inner Mongolia Autonomous Region of the China collaborative study on AKI.In Chapter 2,we classified and graded the AKI by the expanded KDIGO criteria and described the AKI-related clinical characteristics.Our results revealed that the incidence of AKI in Mongolian nationality was similar with that of other nationalities;the age was associated with AKI in a "U-type" model.In Chapter 3,we still evaluated the AKI by the expanded KDIGO criteria and evaluated complicated diseases by theCharlson Comorbidity Index.The risk factors of CA-AKI and HA-AKI were analysed by univariable analysis and multivariable logistic analysis.The results supported that the neutral relation between Mongolian nationality and AKI and the middle-aged population had the lowest risk for AKI.The risk factors for CA-AKI and HA-AKI differed and peptic ulcer was associated with the CA-AKI and cardiac infarction,moderate to severe kidney disease,leukemia and metastatic tumor,glycopeptide,diuretics and proton pump inhibitor were independent risk factors for HA-AKI.In Chapter 4,to demonstrate the relationship between age and AKI,the cases not applicable for AKI differentiation were excluded,the CA-AKI and HA-AKI were diagnosed based on accurate KDIGO standard and age were stratified into every 5 years.The relationship curve of age with AKI incidence showed that young people had higher risk for CA-AKI.That was a noticeable issue.Although the elderly was associated with HA-AKI,the risk increased with age only in the very elderly population.In the Chapter 5,the outcomes of AKI were studied,including the AKI-related lenghth of stay,medical cost and all-cause mortality.The results revealed that the patients with AKI had longer lenghth of stay,more medical cost and higher risk for in-hospital death.To control the interaction effect of AKI and age,we further study the relation between in-hospital mortality and AKI,by age and AKI stratification.The results showed that the AKI and the two AKI categories were all associated with in-hospital death.This study analysed the epidemiological charateristics in hospitalize adult patients in the Inner Mongolia Autonomous Region from various perspective.The nationality and age stratification are novel issues which were not referred previously.These results will improve medical quality and fascinate to hospital management.