Centro Universitário ICESP, Brasília, Distrito Federal, DF, Brasil.
Universidade de Brasília, Brasília, Distrito Federal, DF, Brasil.
J Bras Nefrol. 2021 Oct-Dec;43(4):580-585. doi: 10.1590/2175-8239-JBN-2020-0191.
Acute kidney injury (AKI) is a frequent syndrome affecting patients admitted to intensive care units (ICU), and it is associated with poor clinical outcomes. The aim of the present study was to understand the epidemiological profile of patients with AKI admitted to ICUs.
Prospective cohort study, carried out in three ICUs in the Federal District, Brazil. Between October/2017 and December/2018, 8,131 patients were included in the cohort. AKI was defined according to the KDIGO criteria. The main outcomes assessed were AKI development and mortality within 28 days of hospitalization.
Of the 8,131 patients followed up, 1,728 developed AKI (21.3%). Of the 1,728 patients with AKI, 1,060 (61.3%) developed stage 1, while stages 2 and 3 represented 154 (8.9%) and 514 (29.7%), respectively. Of these, 459 (26.6%) underwent renal replacement therapy. The mortality was 25.7% for those with AKI, and 4.9% for those without AKI.
Patients with AKI had higher mortality rates when compared to those without AKI. Likewise, among patients with AKI, higher disease stages were associated with higher death occurrences. AKI incidence (21.3%) and mortality (25.7%) in our study is in line with the largest meta-analysis ever conducted, in which incidence and mortality of 21.6 and 23.9% were observed, respectively. These findings confirm the importance of establishing the KDIGO guideline for the definition and management of AKI in Brazilian ICUs.
急性肾损伤（AKI）是一种常见的综合征，影响入住重症监护病房（ICU）的患者，与不良临床结局相关。本研究旨在了解入住 ICU 的 AKI 患者的流行病学特征。
前瞻性队列研究，在巴西联邦区的 3 个 ICU 进行。2017 年 10 月至 2018 年 12 月，共纳入 8131 例患者入组。AKI 根据 KDIGO 标准定义。主要结局评估为住院后 28 天内 AKI 发展和死亡率。
在随访的 8131 例患者中，1728 例发生 AKI（21.3%）。在 1728 例 AKI 患者中，1060 例（61.3%）发生 1 期，2 期和 3 期分别为 154 例（8.9%）和 514 例（29.7%）。其中，459 例（26.6%）接受了肾脏替代治疗。AKI 患者的死亡率为 25.7%，无 AKI 患者的死亡率为 4.9%。
与无 AKI 患者相比，AKI 患者的死亡率更高。同样，在 AKI 患者中，较高的疾病分期与更高的死亡发生率相关。本研究中 AKI 的发生率（21.3%）和死亡率（25.7%）与之前进行的最大规模荟萃分析一致，分别观察到发生率和死亡率为 21.6%和 23.9%。这些发现证实了在巴西 ICU 中建立 KDIGO 指南定义和管理 AKI 的重要性。
