Analysis Of Incidence And Risk Factors In Adult Hospitalized Patients With Acute Kidney Injury

Objective To heip clinicians better understand and prevent AKI and improve the prognosis of patients,we retrospectively analyzed the characteristics of AKI in adult hospitalized patients and risk factors that aggravate the severity of AKI.Metheds The hospital information management system was applied to select all the clinical information of hospitalized patients of The Second Affiliated Hospital of Anhui Medical University from January 2014 to December 2016.AKI patients with complete medical history were screened according to the AKI diagnostic criteria recommended by the KDIGO guide to form a study cohort.Their general situation,incidence,etiology and distribution characteristics were retrospectively analyzed.Logistic regression analysis was conducted to investigate the risk factors influencing the severity of AKI.Results 1.2132 patients suffering from AKI were enrolled,the incidence of AKI in hospitalized patients was 1.4%(2132/156659),the ratios of stage 1,2 and 3 AKI were78.5%,18.4% and 3.1% respectively,and the mortality of AKl was 9.3%(199/2132).2.The male-female ratio was 1.37:1(1233:899),with a median age of 61(48,70)years old.Male patients were more common,and the incidence of AKI gradually increased with age.3.Analysis of the causes of AKI showed that pre-AKI accouted for54.7%,followed by renal parenchyma AKI(38.9%)and postrenal AKI(6.4%).The inducement that causes AKI and pathogeny were various in which surgery and drug-related AKI were the most common.The most common clinical type for AKI was inadequacy of effective blood volume(47.6%)and acute tubular necrosis(ATN,37.1%).4.Multivariate logistic regression analysis showed that extra-renal organ failure(OR=4.016,95%CI 3.005-5.367,P < 0.001),oliguria(OR=2.674,95%CI 1.994-3.584,P <0.001),history of hypotension in the previous 1 week(OR=1.773,95%CI 1.259-2.497,P=0.001),chronic kidney disease(CKD)(OR=2.258,95%CI 1.326-3.842,P=0.003)and the use of iodine contrast agent(OR=1.711,95%CI 1.184-2.473,P=0.004)were independent risk factors for the stage 2 and 3 AKI.Conclusions AKI was a common clinical syndrome with high incidence and mortality in adult hospitalized patients,which was easy to be missed.Prerenal AKI and ATN were the most common clinical type of AKI.Extra-renal organ failure,CKD,oliguria,history of hypotension in the previous 1 week and use of iodine contrast agent were independent risk factors which seriously affected the severity of AKI.