Prognostic Risk Factors Of Hospital Acquired Acute Kidney Injury In Intensive Care Unit Patients

Objective: To explore the prognostic risk factors of patients with hospital-acquired acute kidney injury(HA-AKI)in intensive care unit.Methods: Taking 114 adult patients with HA-AKI after admission to intensive care unit of affiliated hospital of Qinghai University from August 01,2017 to July 31,2018 as the research object,general data,clinical data and laboratory data were collected to investigate the clinical characteristics and renal function turnover of severe patients with HA-AKI.According to the prognosis of renal function,it is divided into renal function recovery group and renal function non-recovery group.First,single factor analysis is carried out,and then the single factor with statistical difference is classified into binary Logistic regression analysis to obtain the prognosis risk factors of HA-AKI in intensive care unit.Results: 1.In general data,the age of the group without renal function recovery is older than that of the group with renal function recovery(P <0.05);There was no significant difference of Gender between the two groups(P >0.05).2.Comparing the main causes of the two groups,AKI renal function is not easy to recover due to surgery,sepsis and hypotension(P <0.05),and application of nephrotoxic drugs does not affect renal function recovery(P >0.05).The application of RRT affected the recovery of renal function(P <0.05).There were significant differences in AKI staging and the number of extrarenal organ failure between the two groups(P <0.05).There was no significant difference in hypertension,diabetes,coronary heart disease,pulmonary heart disease,chronic obstructive pulmonary disease and atherosclerosis history between the two groups(P >0.05).3.In the laboratory data,ALB in the group without renal function recovery was lower than that in the recovery group(P <0.05),and the positive rate of U-PRO was higher than that in the renal function recovery group(P <0.05).Hb,WBC,NEUT%,PLT,ALT,TB,Myo,TC,LDL-c,UA had no significant difference between the two groups(P >0.05).4.Prognostic risk factors analysis showed that age(P <0.05,OR=0.956,95%CI:0.918,0.995),sepsis(P <0.05,OR=0.187,95%CI:0.053,0.665),number of extrarenal organ failure(P<0.05,OR=0.160,95%CI:0.064,0.403)and U-PRO(P<0.05,OR=0.285,95%CI:0.085,0.955)were the causes of acute kidney injury in severe patients.Conclusions: The independent risk factors for prognosis of severe patients with HA-AKI are age,sepsis,number of extrarenal organ failure,and U-PRO.