Incidence and Risk Factors for Early Acute Kidney Injury in Nonsurgical Patients: A Cohort Study.

. Detecting acute kidney injury (AKI) in the first days of hospitalization could prevent potentially fatal complications. However, epidemiological data are scarce, especially on nonsurgical patients. . To determine the incidence and risk factors associated with AKI within five days of hospitalization (EAKI). . Prospective cohort of patients hospitalized in the Internal Medicine Department. . A total of 16% of 400 patients developed EAKI. The associated risk factors were prehospital treatment with nephrotoxic drugs (2.21 OR; 95% CI 1.12-4.36, = 0.022), chronic kidney disease (CKD) in stages 3 to 5 (3.56 OR; 95% CI 1.55-8.18, < 0.003), and venous thromboembolism (VTE) at admission (5.05 OR; 95% CI 1.59-16.0, < 0.006). The median length of hospital stay was higher among patients who developed EAKI (8 [IQR 5-14] versus 6 [IQR 4-10], = 0.008) and was associated with an increased requirement for dialysis (4.87 OR 95% CI 2.54 to 8.97, < 0.001) and in-hospital death (3.45 OR; 95% CI 2.18 to 5.48, < 0.001). . The incidence of EAKI in nonsurgical patients is similar to the worldwide incidence of AKI. The risk factors included CKD from stage 3 onwards, prehospital treatment with nephrotoxic drugs, and VTE at admission. EAKI is associated with prolonged hospital stay, increased mortality rate, and dialysis requirement.