Clinical Characteristics, Treatments, and Outcomes of Acute Kidney Injury in Critically Ill Patients at Siriraj Hospital

Duangporn Saepian; Surat  Tongyoo; Thummaporn  Naorungroj

doi:10.33192/smj.v78i7.277510

Authors

Duangporn Saepian Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Surat Tongyoo Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Thummaporn Naorungroj Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v78i7.277510

Keywords:

Acute kidney injury, mortality, intensive care unit, critically Ill, Thailand

Abstract

Objective: This study aimed to investigate the prevalence, clinical outcomes, and predictive factors of AKI among
intensive care unit (ICU) patients at Siriraj Hospital.

Materials and Methods: We conducted a single-center retrospective study of ICU patients admitted between January 2014 and December 2021. The primary outcome was hospital mortality following ICU admission.

Results: Of the 1,950 patients included, 1,453 (74.5%) developed AKI, with 14.3% classified as stage 1, 12.9% as stage 2, and 47.3% as stages 3. The hospital mortality rate was significantly higher in the AKI group compared to the non-AKI group (49.6% vs. 17.9%, p < 0.01). The highest mortality rate was observed in patients with stage 3 AKI (60.6%, p < 0.001). Additionally, patients with AKI had longer ICU stays (32 vs. 22 days; p < 0.001) and a higher prevalence of nosocomial infections (39.8% vs. 26.6%; p < 0.001). Multivariable analysis identified a Non-renal Sequential Organ Failure Assessment (SOFA) score > 6, urine output <1 ml/kg/h, vasopressor use, and hypertension as factors associated with AKI.

Conclusion: AKI was relatively common among critically ill patients in this cohort, and its presence and severity were associated with worse clinical outcomes. High SOFA scores, low urine output, vasopressor use, and hypertension were identified as factors associated with AKI.

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