Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study
- 2.2k Downloads
We aimed to determine the incidence, risk factors and outcome of acute kidney injury (AKI) in Finnish ICUs.
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.
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.
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.
KeywordsAcute kidney injury Epidemiology Intensive care Outcome Mortality AKIN KDIGO
We thank Tieto Healthcare and Welfare Ltd for database management. We received Clinical Research funding (EVO) TYH 2010109/2011210 and T102010070 from Helsinki University Hospital and grants from the Finnish Society of Intensive Care, the Academy of Finland and the Juselius Foundation. SN has received a grant from the Finnish Society of Anaesthesiologists.
- 5.Liet JM, Dejode JM, Joram N, Gaillard Le Roux B, Pereon Y (2012) Bedside diagnosis of bilateral diaphragmatic paralysis. Intensive Care Med. doi: 10.1007/s00134-012-2729-3
- 15.Pappalardo F, Pieri M, Greco T, Patroniti N, Pesenti A, Arcadipane A, Ranieri VM, Gattinoni L, Landoni G, Holzgraefe B, Beutel G, Zangrillo A (2012) Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med. doi: 10.1007/s00134-012-2747-1
- 19.Cartin-Ceba R, Kojicic M, Li G, Kor DJ, Poulose J, Herasevich V, Kashyap R, Trillo-Alvarez C, Cabello-Garza J, Hubmayr R, Seferian EG, Gajic O (2011) Epidemiology of critical care syndromes, organ failures, and life-support interventions in a suburban US community. Chest 140:1447–1455PubMedCrossRefGoogle Scholar
- 21.Cruz DN, Bolgan I, Perazella MA, Bonello M, de Cal M, Corradi V, Polanco N, Ocampo C, Nalesso F, Piccinni P, Ronco C (2007) North East Italian prospective hospital renal outcome survey on acute kidney injury (NEiPHROS-AKI): targeting the problem with the RIFLE criteria. Clin J Am Soc Nephrol 2:418–425PubMedCrossRefGoogle Scholar
- 22.Piccinni P, Cruz DN, Gramaticopolo S, Garzotto F, Dal Santo M, Aneloni G, Rocco M, Alessandri E, Giunta F, Michetti V, Iannuzzi M, Belluomo Anello C, Brienza N, Carlini M, Pelaia P, Gabbanelli V, Ronco C (2011) Prospective multicenter study on epidemiology of acute kidney injury in the ICU: a critical care nephrology Italian collaborative effort (NEFROINT). Minerva Anestesiol 77:1072–1083PubMedGoogle Scholar