Rasha Mahmoud Ahmed Shafie, Neveen Lewis Mikhael, Iman Elgohary, Sherif Hegab, Nahed Baddour and Ahmed Adam
Alexandria University, Egypt
: J Kidney
Background: Acute kidney injury (AKI) considered as a major public health problem that affects millions of patients worldwide and leads to decreased survival and increased progression of chronic kidney disease (CKD). Aim: To check incidence of acute kidney injury in patients admitted to Alexandria University Hospitals over six months. Methods: All patients who were admitted to intensive care units (ICUs) at Main Alexandria University Hospitals were prospectively studied. Patients who developed ICU-acquired acute renal failure were collected in the period over six months. Results: Our study included 500 patients in general ICU. General ICU patients classified according to renal impairment: 303 cases (no AKI) 60.6%, 74 cases (CKD) 14.8%, 55 cases (AKI) 11%, 38 cases (acute on top of CKD) 7.6%, 28 cases (ESRD) 5.6%, 2 cases (obstructive uropathy) 0.4%. Bimodal distribution of age in patients developed AKI at 18-30 years of age and 62-85 years of age. 75 toxicological cases, 3 developed AKI (2 organophosphorus and 1 scorpion bite). The most common cause of AKI in our study was septic AKI 60% and among 128 cases of sepsis 32% did not developed AKI, 25.8% developed septic AKI, 32% acute on top of CKD and 10.2% ESRD. Mortality rate all over general ICU patients was 140/500 (28%) while allover AKI patients in general ICU 30/55 (54%) and allover septic AKI 26/33 (79%). AUC was higher for TIMP1 (1.00) followed by TIMP3 (0.99) then NGAL (0.96) then TIMP2 and procalcitonin (0.94) then TIMP4 (0.92) and lastly serum creatinine (0.83). Conclusions: AKI is a worsening problem, but its true incidence is in need of huge work. Our study is 1st in Alexandria to our knowledge to check the incidence of AKI; hence planning for better outcome. TIMP1 followed by TIMP3 then NGAL then TIMP2 and procalcitonin then TIMP4 can predict AKI early before serum creatinine.
