An epidemiologic overview of acute kidney injury in intensive care units
An epidemiologic overview of acute kidney injury in intensive care units
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DOI：
10.1590/1806-9282.65.8.1094
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发表时间：
2019-08-01
期刊：
影响因子：
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通讯作者：
Macedo, Etienne
中科院分区：
文献类型：
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作者：
Santos, Reginaldo Passoni dos;Carvalho, Ariana Rodrigues Silva;Macedo, Etienne
简介：急性肾损伤（acute kidney injury，阿基）是重症监护病房（intensive care units，ICU）危重患者的常见事件，是一个全球性的公共卫生问题，必须进行多学科交叉研究。在线研究Medline，科学电子图书馆在线，拉丁美洲和加勒比健康科学文献数据库，结果：共纳入来自全球不同地区300多个ICU的67,033例患者的数据。阿基的总发生率为2.5%~ 92.2%，死亡率为5%~ 80%。ICU住院时间从5天到21天不等，肾脏替代治疗的需求从0.8%到59.2%不等。阿基患者的死亡率和住院时间明显高于非阿基患者。其中一个原因是界定案件所用的标准不同。当地资源的可用性、肾脏替代治疗需求、ICU入院时的血清肌酐、容量超负荷和脓毒症等都会影响阿基患者的死亡率。
INTRODUCTION: Acute kidney injury (AKI) is a frequent event among critically ill patients hospitalized in intensive care units (ICU) and represents a global public health problem, being imperative an interdisciplinary approach.OBJECTIVE: To investigate, through literature review, the AKI epidemiology in ICUs.METHODS: Online research in Medline, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences databases, with analysis of the most relevant 47 studies published between 2010 and 2017.RESULTS: Data of the 67,033 patients from more than 300 ICUs from different regions of the world were analyzed. The overall incidence of AKI ranged from 2.5% to 92.2%, and the mortality from 5% to 80%. The length of ICU stay ranged from five to twenty-one days, and the need for renal replacement therapy from 0.8% to 59.2%. AKI patients had substantially higher mortality rates and longer hospital stays than patients without AKI.CONCLUSION: AKI incidence presented high variability among the studies. One of the reasons for that were the different criteria used to define the cases. Availability of local resources, renal replacement therapy needs, serum creatinine at ICU admission, volume overload, and sepsis, among others, influence mortality rates in AKI patients.