Acute kidney injury epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Epidemiology and Demographics

AKI in the General Population

Most studies addressing the epidemiology of AKI focus on patients admitted to the hospital due to the high incidence of AKI in that setting. Ali el al conducted a retrospective cohort study in the Grampian region of Scotland involving 523,390 subjects for a span of 6 months. Their results showed an overall 6-month incidence of approximately 0.09% in the general population. The estimated yearly incidence was 1811 pmp for AKI without prior history of kidney disease. Out of the patients with AKI, 53% were males, 67.7% had full renal recovery, and 7.8% required renal replacement therapy. To note, the in-hospital mortality was estimated to be 32.7% while the 6-month mortality approached 50%. [1]

AKI in ICU Patients

Many studies have addressed the epidemiology of AKI in the intensive care unit with varying incidence rates. A trend of increasing incidence of is apparent with reported incidence of 4.9% in 1983, 7.2% in 2002, and up to 67% most recently.[2][3] Thakar et al reported an overall AKI incidence of 22% when studying 323,395 ICU patients admitted to the ICU in Veterans Affairs Hospitals across the USA, 17.5% of which matched the criteria for Stage 1 AKI.[4] The NEiPHROS-AKI study prospectively assessed the incidence rates of AKI in 19 ICUs in northeastern Italy in a 3-month period following the RIFLE criteria and showed a lower incidence of 10.8% in the cohort of 2164 patients.[5] Probably the highest recorded incidence came from Hoste et al who studied 5383 ICU patients with a reported rate of AKI of 67% according to the RIFLE criteria (Class R: 12%, Class I: 27%, Class F: 28%).[6] None of the studies showed any gender preponderance. Generally, lower incidence rates were seen in patients admitted for elective surgery and higher incidence in patients admitted for sepsis.[7]


References

  1. Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W; et al. (2007). "Incidence and outcomes in acute kidney injury: a comprehensive population-based study". J Am Soc Nephrol. 18 (4): 1292–8. doi:10.1681/ASN.2006070756. PMID 17314324.
  2. Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT (1983). "Hospital-acquired renal insufficiency: a prospective study". Am J Med. 74 (2): 243–8. PMID 6824004.
  3. Nash K, Hafeez A, Hou S (2002). "Hospital-acquired renal insufficiency". Am J Kidney Dis. 39 (5): 930–6. doi:10.1053/ajkd.2002.32766. PMID 11979336‎ Check |pmid= value (help).
  4. Thakar CV, Christianson A, Freyberg R, Almenoff P, Render ML (2009). "Incidence and outcomes of acute kidney injury in intensive care units: a Veterans Administration study". Crit Care Med. 37 (9): 2552–8. doi:10.1097/CCM.0b013e3181a5906f. PMID 19602973.
  5. Cruz DN, Bolgan I, Perazella MA, Bonello M, de Cal M, Corradi V; et al. (2007). "North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria". Clin J Am Soc Nephrol. 2 (3): 418–25. doi:10.2215/CJN.03361006. PMID 17699446.
  6. Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D; et al. (2006). "RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis". Crit Care. 10 (3): R73. doi:10.1186/cc4915. PMC 1550961. PMID 16696865.
  7. Case J, Khan S, Khalid R, Khan A (2013). "Epidemiology of acute kidney injury in the intensive care unit". Crit Care Res Pract. 2013: 479730. doi:10.1155/2013/479730. PMC 3618922. PMID 23573420.

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