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Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting

Introduction Acute Kidney Injury (AKI) is common in patients admitted to the intensive care unit, occurring in 30 to 60% of patients. The high incidence of AKI in our population may be attributed to sepsis. Sepsis is the leading cause of ICU admission. The Malaysian Registry of Intensive Care (MRIC...

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Main Authors: Md Ralib, Azrina, Nanyan, Suhaila, Ramly, Nur fariza, Mat Nor, Mohd Basri
Format: Article
Language:English
Published: Elsevier BV 2017
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/58075/1/58075_Prevalence%20of%20acute%20kidney%20injury%20and%20sepsis%20_new.pdf
http://irep.iium.edu.my/58075/
https://doi.org/10.1016/j.ekir.2017.06.034
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spelling my.iium.irep.580752020-11-09T05:38:37Z http://irep.iium.edu.my/58075/ Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting Md Ralib, Azrina Nanyan, Suhaila Ramly, Nur fariza Mat Nor, Mohd Basri R Medicine (General) Introduction Acute Kidney Injury (AKI) is common in patients admitted to the intensive care unit, occurring in 30 to 60% of patients. The high incidence of AKI in our population may be attributed to sepsis. Sepsis is the leading cause of ICU admission. The Malaysian Registry of Intensive Care (MRIC), an annual ICU audit performed in all Malaysian ICUs. This registry serves as an excellent avenue to explore the incidence of septic AKI in our local ICU. Methods This retrospective cohort study extracted de-identified data from the Malaysian Registry of Intensive Care (MRIC) for patients admitted to Hospital Tengku Ampuan Afzan between January and December 2014. The study was registered under the NMRR (NMRR-14-1938-23183) and approved by the ethics committee. AKI was defined as doubling of serum creatinine from baseline value. Results A total of 1059 ICU admissions were analysed. Of these 230 (21.7%) had AKI and 253 (23.9%) had sepsis within 24 hours of admission. Patients with AKI were older and had higher severity of illness compared to those without AKI (p<0.0001). Diabetes mellitus, chronic renal failure and hypertension were more common in patients with AKI. Twenty percent of patients received dialysis, and 23% died. Of those who survived, AKI patients had longer duration of mechanical ventilation, length of ICU and hospital stay (p<0.0001). Seventy-three percent (n=168) of patients with sepsis had AKI (p<0.0001). Conclusions AKI is common in our ICU, with higher morbidity and mortality. Risk factors of AKI includes age, severity of illness, the presence of sepsis and pre-existing diabetes mellitus, chronic renal failure, and hypertension. Future analysis will explore a larger cohort of data involving four tertiary hospitals over a five-year duration. Elsevier BV 2017-08-20 Article PeerReviewed application/pdf en http://irep.iium.edu.my/58075/1/58075_Prevalence%20of%20acute%20kidney%20injury%20and%20sepsis%20_new.pdf Md Ralib, Azrina and Nanyan, Suhaila and Ramly, Nur fariza and Mat Nor, Mohd Basri (2017) Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting. Kidney International Reports, 2 (4 ( Supplement )). 062-062. ISSN 2452-1981 https://doi.org/10.1016/j.ekir.2017.06.034 10.1016/j.ekir.2017.06.034
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Md Ralib, Azrina
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
description Introduction Acute Kidney Injury (AKI) is common in patients admitted to the intensive care unit, occurring in 30 to 60% of patients. The high incidence of AKI in our population may be attributed to sepsis. Sepsis is the leading cause of ICU admission. The Malaysian Registry of Intensive Care (MRIC), an annual ICU audit performed in all Malaysian ICUs. This registry serves as an excellent avenue to explore the incidence of septic AKI in our local ICU. Methods This retrospective cohort study extracted de-identified data from the Malaysian Registry of Intensive Care (MRIC) for patients admitted to Hospital Tengku Ampuan Afzan between January and December 2014. The study was registered under the NMRR (NMRR-14-1938-23183) and approved by the ethics committee. AKI was defined as doubling of serum creatinine from baseline value. Results A total of 1059 ICU admissions were analysed. Of these 230 (21.7%) had AKI and 253 (23.9%) had sepsis within 24 hours of admission. Patients with AKI were older and had higher severity of illness compared to those without AKI (p<0.0001). Diabetes mellitus, chronic renal failure and hypertension were more common in patients with AKI. Twenty percent of patients received dialysis, and 23% died. Of those who survived, AKI patients had longer duration of mechanical ventilation, length of ICU and hospital stay (p<0.0001). Seventy-three percent (n=168) of patients with sepsis had AKI (p<0.0001). Conclusions AKI is common in our ICU, with higher morbidity and mortality. Risk factors of AKI includes age, severity of illness, the presence of sepsis and pre-existing diabetes mellitus, chronic renal failure, and hypertension. Future analysis will explore a larger cohort of data involving four tertiary hospitals over a five-year duration.
format Article
author Md Ralib, Azrina
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
author_facet Md Ralib, Azrina
Nanyan, Suhaila
Ramly, Nur fariza
Mat Nor, Mohd Basri
author_sort Md Ralib, Azrina
title Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
title_short Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
title_full Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
title_fullStr Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
title_full_unstemmed Prevalence of acute kidney injury and sepsis in a Malaysian intensive care setting
title_sort prevalence of acute kidney injury and sepsis in a malaysian intensive care setting
publisher Elsevier BV
publishDate 2017
url http://irep.iium.edu.my/58075/1/58075_Prevalence%20of%20acute%20kidney%20injury%20and%20sepsis%20_new.pdf
http://irep.iium.edu.my/58075/
https://doi.org/10.1016/j.ekir.2017.06.034
_version_ 1683230334326407168
score 13.211869

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