Causes And Risk Factors Of Acute Kidney Injury In83Surgical Abdomen Patients

Objective:To investigate the incidence, common causes and prognosis of acute kidney injury (AKI) in surgical abdomen patients, analyse the risk factors for AKI, so as to early detect, prevent AKI in patients with acute abdomen and improve its prognosis.Methods:This retrospective cohort study was carried out in the emergency surgery department of Tianjin People’s Hospital between September2011and August2012, the study population consisted of287surgical abdomen patients who were hospitalized more than72hours, and were recorded medical data adequately. Than the287patients were assigned into AKI group and non-AKI group, compared the clinical data between the two groups, analyzed the clinical characteristics and the etiology, distribution characteristics and prognosis of AKI, and the multivariate analysis(Logistic regression) were used to identify the risk factors of AKI in acute abdomen patients.Results:83cases complicated with AKI in287patients, the overall incidence of AKI was28.92%, the male to female ratio of patients with AKI was1.9:1. the interquartile range of age was54.5-75years old, and the median age was62years old. The main cause of AKI was prerenal (37cases). According to KDIGO criteria,56cases(67.47%)were at AKI I phase,17cases(20.48%)were at AKI II phase,10cases(12.05%)were at AKI III phrase.Till leaving hospital,58cases (69.88%) recovered renal function fully,18cases (21.69%) patients got partial recovery, and7patients were not recovered (8.43%),6cases died (7.23%).8(9.64%) patients received hemodialysis treatment, in which3cases recovered renal function, independent of dialysis,2cases died and2cases received maintenance hemodialysis (MHD). Univariate analysis relvealed that there were significant differences in age, chronic kidney disease(CKD), hypovolemia, hypoalbuminemia, chronic heart failure (all P<0.05). Four variables were found to be significantly related to the development of AKI by multifactor regression analysis:age≥65y (OR=2.965,P=0.008), CKD (OR=2.849,P=0.000), hypovolemia(OR=2.404,P=0.018), chronic heart failure(OR=4.272,P=0.042). Conclusion:AKI is a common complication in surgical abdomen patients, and the incidence was28.92%, the main cause was hypovolemia. AKI prognosis is related to its stage, the prognosis is poorer with the higher AKI stage.The study shows that age≥65y, CKD, hypovolemia, and chronic heart failure are risk factors most likely associated with AKI development in acute abdomen patients.