An assessment of AKIN criteria for hospital-acquired acute kidney injury: a prospective observational cohort study

Nephron Clin Pract. 2010;116(3):c217-23. doi: 10.1159/000317202. Epub 2010 Jul 2.

Abstract

Background and aims: The Acute Kidney Injury Network (AKIN) criteria assert a new definition for acute kidney injury (AKI). We investigated the incidence of hospital-acquired AKI, along with the clinical characteristics and outcomes in hospitalized patients according to AKIN stage.

Methods: We performed a prospective, observational, single-center study. We monitored serum creatinine everyday for all patients using a hospital data survey system during the study period from September 2007 to February 2008.

Results: Hospital-acquired AKI occurred in 1.2% of all hospitalized patients during the study period. Among patients with AKI, 29.2% were in stage 1, 36.5% were in stage 2 and 34.4% were in stage 3. A significantly higher rate of renal recovery was observed in patients with lower-stage injuries (71.4, 60.0, and 21.2% for stages 1, 2, and 3, respectively). Mortality for patients with stage 3 AKI (51.5%) was significantly higher than that for patients with stages 1 or 2 (p < 0.013). Independent risk factors for mortality in patients with AKI included malignancy, stage 3 AKI, diuretic use, and intensive care unit admission prior to AKI.

Conclusions: Our findings support the utility of the AKIN criteria for hospital-acquired AKI, and demonstrate that stage 3 AKI poses a significant risk for poor patient and renal outcomes.

MeSH terms

  • Acute Kidney Injury / diagnosis*
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Creatinine / blood
  • Diuresis
  • Female
  • Gastrointestinal Diseases / epidemiology
  • Humans
  • Incidence
  • Inpatients / statistics & numerical data
  • Kidney Failure, Chronic / therapy
  • Kidney Function Tests
  • Lung Diseases / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Prognosis
  • Prospective Studies
  • Renal Replacement Therapy
  • Republic of Korea / epidemiology
  • Risk Factors
  • Severity of Illness Index*
  • Treatment Outcome

Substances

  • Creatinine