Acute Kidney Injury (AKI) is a growing public health problem associated with poor outcomes [1]. It affects over 13 million people per year globally, 58% of hospitalized patients, and 30- 60% of critically ill patients. More than 80% of those patients live in the developing world [3-5]. AKI is the most frequent cause of organ dysfunction in critically ill patients, with a single episode, regardless of stage, carrying a significant morbidity and mortality risk [6]. Two trials, namely program to improve care in acute renal disease (PICARD)[7] and beginning and ending supportive therapy (BEST)[8] for the kidney, confirmed that AKI is a significant contributor toward mortality and morbidity among ICU patients.
The negative effect of AKI on patients
It was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Baseline serum creatinine (Scr) values were determined through review of Scr values taken from the patients’ hospital records on the dayof hospital admission before admission to ICU. When no baseline Scr was available, the lowest reading in the repeated measurement of Scr during ICU stay was considered as the baseline, otherwise the upper limit of normal laboratory reference range for sCr in men and women was considered as the baseline. Patients with preexisting chronic kidney disease (CKD) that sustained acute-on-chronic kidney injury were included. CKD was identified based on the clinical
While, multiple Cox regression was used to identify the predictors of HAKI and death. We used linear regression analysis to evaluate the associations of AKI with ICU length of stay. Variables selected for inclusion in the regression model were those with biological or plausible rationale and a p value of 0.10 or less in univariate analysis. The model’s goodness of fit was tested with the Hosmer-Lemeshow statistic.
Statistical significance was accepted when the p value was less than 0.05 (double sided). Statistical analysis was performed with the software packages SPSS statistics version 20 (IBM Corporation and others, NY, USA) and STATA version 11
Table 1 summarizes the demographic and baseline characteristics of the study cohort. The study cohort included 532 subjects who were on average 46 year old (±18), 41.7% were males, 23.5% with smoking, 23.1% had diabetes ,34.8%, were hypertensive, 11.3 % with pre-existing CKD, 5% with COPD, and one third (30.1%) had cardiovascular diseases. Malignancies were prevalent among 12.2% while 10% had liver diseases. The main reasons for ICU admission were neuropsychiatry (22%), trauma (14.1%), and pulmonary (14.1%). Patients admitted at surgical ICU units in 61.7% of the