Santos Reginaldo Passoni Dos, Carvalho Ariana Rodrigues Silva, Peres Luis Alberto Batista, Ronco Claudio, Macedo Etienne
Programa de Pós-Graduação em Biociências e Saúde, Universidade Estadual do Oeste do Paraná - Cascavel, PR, Brasil.
Departamento de Enfermagem, Universidade Estadual do Oeste do Paraná - Cascavel, PR, Brasil.
Rev Assoc Med Bras (1992). 2019 Sep 12;65(8):1094-1101. doi: 10.1590/1806-9282.65.8.1094.
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.
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.
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.
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.
急性肾损伤（AKI）在入住重症监护病房（ICU）的危重症患者中很常见，是一个全球性公共卫生问题，需要采取跨学科方法。
通过文献综述调查ICU中AKI的流行病学情况。方法：在医学在线数据库（Medline）、科学电子图书馆在线数据库（Scientific Electronic Library Online）以及拉丁美洲和加勒比地区健康科学文献数据库中进行在线检索，分析2010年至2017年间发表的47项最相关研究。
分析了来自世界不同地区300多个ICU的67033例患者的数据。AKI的总体发病率在2.5%至92.2%之间，死亡率在5%至80%之间。ICU住院时间在5至21天之间，肾脏替代治疗的需求率在0.8%至59.2%之间。与无AKI的患者相比，AKI患者的死亡率显著更高，住院时间更长。
各项研究中AKI的发病率差异很大。其中一个原因是用于定义病例的标准不同。当地资源的可用性、肾脏替代治疗需求、入住ICU时的血清肌酐水平、容量超负荷以及脓毒症等因素都会影响AKI患者的死亡率。
