Intensive Care Medicine

, Volume 39, Issue 3, pp 420–428 | Cite as

Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study

  • Sara Nisula
  • Kirsi-Maija Kaukonen
  • Suvi T. Vaara
  • Anna-Maija Korhonen
  • Meri Poukkanen
  • Sari Karlsson
  • Mikko Haapio
  • Outi Inkinen
  • Ilkka Parviainen
  • Raili Suojaranta-Ylinen
  • Jouko J. Laurila
  • Jyrki Tenhunen
  • Matti Reinikainen
  • Tero Ala-Kokko
  • Esko Ruokonen
  • Anne Kuitunen
  • Ville Pettilä
  • The FINNAKI Study Group
Original

Abstract

Purpose

We aimed to determine the incidence, risk factors and outcome of acute kidney injury (AKI) in Finnish ICUs.

Methods

This prospective, observational, multi-centre study comprised adult emergency admissions and elective patients whose stay exceeded 24 h during a 5-month period in 17 Finnish ICUs. We defined AKI first by the Acute Kidney Injury Network (AKIN) criteria supplemented with a baseline creatinine and second with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We screened the patients’ AKI status and risk factors for up to 5 days.

Results

We included 2,901 patients. The incidence (95 % confidence interval) of AKI was 39.3 % (37.5–41.1 %). The incidence was 17.2 % (15.8–18.6 %) for stage 1, 8.0 % (7.0–9.0 %) for stage 2 and 14.1 % (12.8–15.4 %) for stage 3 AKI. Of the 2,901 patients 296 [10.2 % (9.1–11.3 %)] received renal replacement therapy. We received an identical classification with the new KDIGO criteria. The population-based incidence (95 % CI) of ICU-treated AKI was 746 (717–774) per million population per year (reference population: 3,671,143, i.e. 85 % of the Finnish adult population). In logistic regression, pre-ICU hypovolaemia, diuretics, colloids and chronic kidney disease were independent risk factors for AKI. Hospital mortality (95 % CI) for AKI patients was 25.6 % (23.0–28.2 %) and the 90-day mortality for AKI patients was 33.7 % (30.9–36.5 %). All AKIN stages were independently associated with 90-day mortality.

Conclusions

The incidence of AKI in the critically ill in Finland was comparable to previous large multi-centre ICU studies. Hospital mortality (26 %) in AKI patients appeared comparable to or lower than in other studies.

Keywords

Acute kidney injury Epidemiology Intensive care Outcome Mortality AKIN KDIGO 

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2012

Authors and Affiliations

  • Sara Nisula
    • 1
  • Kirsi-Maija Kaukonen
    • 1
  • Suvi T. Vaara
    • 1
  • Anna-Maija Korhonen
    • 1
  • Meri Poukkanen
    • 2
  • Sari Karlsson
    • 3
    • 4
  • Mikko Haapio
    • 5
  • Outi Inkinen
    • 6
  • Ilkka Parviainen
    • 7
  • Raili Suojaranta-Ylinen
    • 1
  • Jouko J. Laurila
    • 8
  • Jyrki Tenhunen
    • 4
  • Matti Reinikainen
    • 3
  • Tero Ala-Kokko
    • 8
  • Esko Ruokonen
    • 7
  • Anne Kuitunen
    • 4
  • Ville Pettilä
    • 1
    • 9
  • The FINNAKI Study Group
  1. 1.Division of Anaesthesia and Intensive Care Medicine Department of Surgery, Intensive Care UnitsHelsinki University Central HospitalHelsinkiFinland
  2. 2.Department of Anesthesia and Intensive Care MedicineLapland Central HospitalRovaniemiFinland
  3. 3.Department of Intensive CareNorth Karelia Central HospitalJoensuuFinland
  4. 4.Department of Intensive Care MedicineTampere University HospitalTampereFinland
  5. 5.Department of NephrologyHelsinki University Central HospitalHelsinkiFinland
  6. 6.Department of Anesthesia and Intensive Care MedicineTurku University HospitalTurkuFinland
  7. 7.Division of Intensive CareKuopio University HospitalKuopioFinland
  8. 8.Division of Intensive Care, Department of AnesthesiologyOulu University HospitalOuluFinland
  9. 9.Institute of Clinical MedicineUniversity of HelsinkiHelsinkiFinland

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