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Acute renal failure in the ICU setting: A prospective observational study
Shivinder Singh1, A K Patra2, Barun Patel3
1Senior Adviser (Anaesthesiology & Critical Care), Command Hospital (Western Command), Chandimandir, Haryana, India.
Medical Journal, Armed Forces India
|August 23, 2016
Summary
Acute kidney injury (AKI) affects 17.2% of intensive care unit patients, particularly those with sepsis or polytrauma. Early monitoring in the first 3-4 days is crucial for prevention and timely intervention.
Area of Science:
- Nephrology
- Critical Care Medicine
- Internal Medicine
Background:
- Acute renal failure (ARF) is prevalent in intensive care units (ICUs).
- Limited data exists on acute kidney injury (AKI) incidence in national ICUs.
- No prior data available from the service setting.
Purpose of the Study:
- To determine the incidence of AKI in a tertiary care teaching hospital's ICU.
- To identify risk factors and patient groups susceptible to AKI development.
- To compare AKI development between surgical and medical ICU patients.
Main Methods:
- Prospective study of ICU patients over six months.
- Patients categorized into surgical ICU (surg gr) and medical ICU (med gr) groups.
- AKI diagnosis based on creatinine levels and urine output, staged using RIFLE criteria.
Main Results:
- 17.15% of ICU patients developed AKI.
- 40% of sepsis patients developed AKI; peak susceptibility on day 4.
- Surgical ICU patients had higher SOFA scores on admission and AKI development compared to medical ICU patients.
Conclusions:
- The overall ARF incidence was 17.2%, with polytrauma/MODS patients being a major concern.
- The critical period for AKI development is within the first 3-4 days of ICU admission.
- Medical ICU patients require greater attention due to developing ARF at lower SOFA scores than surgical ICU patients.
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