Clinical and epidemiological aspects of acute kidney injury in incident hemodialysis cases at public hospital in Espírito Santo
DOI:
https://doi.org/10.62827/eb.v23i1.j675Keywords:
acute kidney injury; health profile; hemodialysis; public hospital.Abstract
Introduction: Acute Kidney Injury (AKI) is a condition characterized by the sudden loss of renal function, with severe consequences for patients. It serves as a poor prognostic indicator in hospitalized patients, with increased rates of morbidity and mortality. Objective: To describe the clinical-epidemiological profile and the progression of hospitalized patients requiring renal replacement therapy (RRT) through hemodialysis at a public hospital in Espírito Santo. Methods: This is a descriptive, prospective, and observational study of a case series involving patients who initiated hemodialysis at the hospital. Demographic and clinical information of the patients, as well as data related to nephrological care, were collected. Results: AKI predominantly affected patients with low educational and income levels, dependent on the public healthcare system. Sepsis was the leading cause of AKI, and the time between admission and nephrologist evaluation significantly impacted patient prognosis. Conclusion: There is a high mortality rate among AKI patients requiring RRT, emphasizing the importance of early diagnosis and proper management of this condition. The study also highlighted the need for measures to prevent AKI and improve access to renal treatment for low-income patients.
References
Costa JAC, Vieira Neto OM, Moysés Neto M. Insuficiência renal aguda. Medicina, Ribeirão Preto, 2003;36:307–324. Available from: http://revista.fmrp.usp.br/index.htm.
Nunes TF, Brunetta DM, Leal CM, Pisi PCB, Roriz-Filho JS. Insuficiência renal aguda. Medicina (Ribeirão Preto) 2010;43(3): 272-82 doi:http://dx.doi.org/10.11606/issn.2176-7262.v43i3p272-282
Ponce D, Pietro C, Zorzenon F, Santos NY, Teixeira UA, Balbi AL. Injúria renal aguda em unidade de terapia intensiva: Estudo prospectivo sobre a incidência, fatores de risco e mortalidade. Rev. Bras. Ter. Intensiva. 2011;23(3):321–326
Case J, Khan S, Khalid R, Khan A. Epidemiology of acute kidney injury in the intensive care unit. Crit Care Res Pr. 2013;2013:479730. doi: 10.1155/2013/479730
Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, et al. World incidence of AKI: A meta-analysis. Clin. J. Am. Soc. Nephrol. 2013;8(9):1482–1493Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: A prospective study. Am. J. Med. 1983;74(2):243–248
Corwin, HL; Bonventre, JV. Factors Influencing Survival in Acute Renal Failure. Seminars in Dialysis. 1989;2: 220–225. doi:10.1111/j.1525-139X.1989.tb00617.x
Shusterman N, Strom BL, Murray TG, Morrison G, West SL, Maislin G. Risk factors and outcome of hospital-acquired acute renal failure. Clinical epidemiologic study. Am. J. Med. 1987;83(1):65–71
Kellum JA, Levin N, Bouman C, Lameire N. Developing a consensus classification system for acute renal failure. Curr. Opin. Crit. Care. 2002;8(6):509–514
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann E A, Goldstein SL, et al. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int. Suppl. 2012;2(1):1–138
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit. Care. 2004;8(4):R204-12
Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Critical Care. 2007;11(2):R31. doi:10.1186/cc5713.
Hoste EAJ, Schurgers M. Epidemiology of acute kidney injury: How big is the problem? Crit. Care Med. 2008;36(Suppl):S146–S151. doi: 10.1097/CCM.0b013e318168c590
Bagasha P, Nakwagala F, Kwizera A, Ssekasanvu E, Kalyesubula R. Acute kidney injury among adult patients with sepsis in a low-income country: clinical patterns and short-term outcomes. BMC Nephrol. 2015;16:4. https://doi.org/10.1186/1471-2369-16-4
Fujii T, Uchino S, Takinami M, Bellomo R. Validation of the Kidney Disease Improving Global Outcomes Criteria for AKI and Comparison of Three Criteria in Hospitalized Patients. Clinical Journal of the American Society of Nephrology : CJASN. 2014;9(5):848-854
Zarbock A, John S, Jörres A, Kindgen-Milles D. Neue KDIGO-Leitlinien zur akuten Nierenschädigung. Der Anaesthesist. 2014 2014/07/01;63(7):578-88
Uchino S. The epidemiology of acute renal failure in the world. Curr. Opin. Crit. Care [Internet]. 2006;12(6):538–543. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00075198-200612000-00004
Lameire N, Biesen W Van, Vanholder R. The changing epidemiology of acute renal failure. Nat. Clin. Pract. Nephrol. 2006;2(7):364–377
Waikar SS, Liu KD, Chertow GM. Diagnosis, epidemiology and outcomes of acute kidney injury. Clin. J. Am. Soc. Nephrol. 2008;3(3):844–861
Hsu C-Y, McCulloch CE, Fan D, Ordoñez JD, Chertow GM, Go AS. Community-based incidence of acute renal failure. Kidney Int. [Internet]. 2007;72(2):208–12. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2673495&tool=pmcentrez&rendertype=abstract
Torchi TS, Carvalho De Araújo ST, Monteiro Moreira AG, Oliveira Koeppe GB, Uchoa Dos Santos BT. Condições clínicas e comportamento de procura de cuidados de saúde pelo paciente renal crônico. ACTA Paul. Enferm. 2014;27(6):585–590
Pereira BJ, Barreto S, Gentil T, Assis LS, Soeiro EM, Castro I de, et al. Risk factors for the progression of chronic kidney disease after acute kidney injury. J. Bras. Nefrol. 2017;0
Wang X, Jiang L, Wen Y, Wang M-P, Li W, Li Z-Q, et al. Risk factors for mortality in patients with septic acute kidney injury in intensive care units in Beijing, China: a multicenter prospective observational study. Biomed Res. Int. [Internet]. 2014;2014:172620. Available from: http://www.hindawi.com/journals/bmri/2014/172620/%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/25110659%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4109370
Rewa O, Bagshaw SM. Acute kidney injury—epidemiology, outcomes and economics. Nat. Rev. Nephrol. [Internet]. 2014;10(4):193–207. Available from: http://www.nature.com/doifinder/10.1038/nrneph.2013.282
and economics. Nat. Rev. Nephrol. [Internet]. 2014;10(4):193–207. Available from: http://www.nature.com/doifinder/10.1038/nrneph.2013.282
Ishani A, Xue JL, Himmelfarb J, Eggers PW, Kimmel PL, Molitoris BA, et al. Acute Kidney Injury Increases Risk of ESRD among Elderly. J. Am. Soc. Nephrol. [Internet]. 2009;20(1):223–228. Available from: http://www.jasn.org/cgi/doi/10.1681/ASN.2007080837
Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, et al. Septic Acute Kidney Injury in Critically Ill Patients: Clinical Characteristics and Outcomes. Clin. J. Am. Soc. Nephrol. [Internet]. 2007;2(3):431–439. Available from: http://cjasn.asnjournals.org/cgi/doi/10.2215/CJN.03681106
Riyuzo MC, Silveira LV de A, Macedo CS, Fioretto JR. Predictive factors of mortality in pediatric patients with acute renal injury associated with sepsis. J. Pediatr. (Rio. J). [Internet]. 2017;93(1):28–34. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0021755716300754
Chertow GM. Acute Kidney Injury, Mortality, Length of Stay, and Costs in Hospitalized Patients. J. Am. Soc. Nephrol. [Internet]. 2005;16(11):3365–3370. Available from: http://www.jasn.org/cgi/doi/10.1681/ASN.2004090740
Gaião SM, Gomes AA, Carvalho Paiva JAO De. Prognostics factors for mortality and renal recovery in critically ill patients with acute kidney injury and renal replacement therapy. Rev. Bras. Ter. Intensiva. 2016;28(1):70–77
Teles F, Mef T, Lla DA, Cru L, Ro S. Impact of a Timely Nephrologic Consultation in Acute Kidney Injury in a Public Hospital. 2016;3(January 2011)
Perrone RD, Madias NE, Levey AS. Serum creatinine as an index of renal function: New insights into old concepts. Clin. Chem. 1992;38(10):1933–1953
Luft J, Boes AA, Lazzari DD, Nascimento ERP do, Busana J de A, Canever BP. Lesão renal aguda em unidade de tratamento intensivo: Características clínicas e desfechos. Cogitare Enferm. [Internet]. 2016;21(2):1–9. Available from: http://ojs.c3sl.ufpr.br/ojs2/index.php/cogitare/
Triquez SL, Dallacosta FM. Perfil Dos Pacientes Com Insuficiência Renal Aguda Na Unidade De Terapia Intensiva E. 2012;123–130
Coca S. Acute kidney injury in elderly persons. Am. J. Kidney Dis. 2010;56(1):122–131
Girndt M, Funk I, Seibert E, Markau S. Clinical Course of Acute Kidney Injury in Elderly Individuals Above 80 Years. Kidney Blood Press Res [Internet]. 2016;41:947–955. Available from: www.karger.com/kbr
Cusumano A, Garcia GG, Gioia C Di, Herminda O, Lavorato C. The latin american dialysis and transplantation registry (RLDT) annual report 2004. Ethn. Dis. 2006;16:10–13
Sandberg K, Ji H. Sex and the renin angiotensin system: Implications for gender differences in the progression of kidney disease. Adv. Ren. Replace. Ther. [Internet]. 2003;10(1):15–23. Available from: http://dx.doi.org/10.1053/jarr.2003.50006
Kang D-H, Yu ES, Yoon K-I, Johnson R. The impact of gender on progression of renal disease: potential role of estrogen-mediated vascular endothelial growth factor regulation and vascular protection. Am. J. Pathol. [Internet]. 2004;164(2):679–88. Available from: http://www.sciencedirect.com/science/article/pii/S0002944010631550
Mascarenhas CHM, Reis LA dos, Lyra JE, Peixoto AV, Teles M dos S. Insuficiência Renal Crônica: caracterização sóciodemográfica e de saúde de pacientes em tratamento hemodialítico no município de jequié/BA. Rev. Espaço para a Saúde. 2010;12(1):30–37
Mônica C De, Santesso CAV, Antônio DS, Fernandes CME. Qualidade de vida de pacientes com insuficiência renal Crônica em hemodiálise avaliada através do instrumento genérico SF-36. Rev. Assoc. Med. Bras. 2003;49(3):245–249
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