Division of Nephrology, Department of Internal Medicine, Gatot Soebroto Indonesia Central Army Hospital, Jakarta, Indonesia.
Department of Anesthesiology and Reanimation, Gatot Soebroto Indonesia Central Army Hospital, Jakarta, Indonesia.
BMC Nephrol. 2020 May 20;21(1):191. doi: 10.1186/s12882-020-01849-y.
Currently, there is limited epidemiology data on acute kidney injury (AKI) in Indonesia. Therefore, we assessed the incidence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia.
Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria.
Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5% had stage 1, 33% had stage 2, and 48.5% had stage 3. Primary diagnosis of renal disease and high APACHE II score were the risk factors associated with AKI (OR = 4.53, 95% CI: 1.67-12.33, p = 0.003 and OR = 1.14 per 1 unit increase, 95% CI: 1.09-1.20, p < 0.001, respectively). Chronic kidney disease was the risk factor for severe AKI. Sepsis was the leading cause of AKI. Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (71.7%), followed by slow low-efficiency dialysis (22.8%), continuous renal replacement therapy (4.3%), and peritoneal dialysis (1.1%).
This study showed that AKI was a common problem in the Indonesian ICU. We strongly believe that identification of the risk factors associated with AKI will help us develop a predictive score for AKI so we can prevent and improve AKI outcome in the future.
目前，印度尼西亚关于急性肾损伤（AKI）的流行病学数据有限。因此，我们评估了印度尼西亚 AKI 的发生率和肾脏替代治疗（RRT）的应用情况。
从 952 名 ICU 参与者中收集人口统计学和临床数据。将参与者分为 AKI 组和非 AKI 组。根据 KDIGO 标准，将参与者进一步分为 AKI 的 3 个不同阶段。
AKI 的总发生率为 43%。根据 AKI 分期，将参与者分为三组：1 期占 18.5%，2 期占 33%，3 期占 48.5%。肾脏疾病的主要诊断和较高的 APACHE II 评分是 AKI 的危险因素（OR=4.53，95%CI：1.67-12.33，p=0.003 和 OR=每增加 1 单位增加 1.14，95%CI：1.09-1.20，p<0.001）。慢性肾脏病是严重 AKI 的危险因素。脓毒症是 AKI 的主要原因。在 AKI 参与者中，24.6%需要 RRT。最常见的 RRT 方式是间歇性血液透析（71.7%），其次是缓慢低效透析（22.8%）、连续肾脏替代治疗（4.3%）和腹膜透析（1.1%）。
本研究表明 AKI 是印度尼西亚 ICU 中的常见问题。我们坚信，确定与 AKI 相关的危险因素将有助于我们开发 AKI 的预测评分，以便我们能够预防和改善未来 AKI 的结果。
