Outcomes in acute kidney injury in noncritically ill patients lately referred to nephrologist in a developing country: a comparison of AKIN and KDIGO criteria
| Autor: | Juarez Duarte de Carvalho Neto, Marcela do Nascimento Silva, Ludgero Ribeiro Feitosa Filho, Jessica Duarte Antão, Ginivaldo Victor Ribeiro do Nascimento |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Delayed Diagnosis Developing country medicine.medical_treatment lcsh:RC870-923 Severity of Illness Index Blood Urea Nitrogen Time-to-Treatment Renal Dialysis Internal medicine medicine Humans Developing Countries Referral and Consultation Blood urea nitrogen Nephrologist referral Dialysis Retrospective Studies business.industry Mortality rate Acute kidney injury Retrospective cohort study Odds ratio Middle Aged lcsh:Diseases of the genitourinary system. Urology medicine.disease Treatment Outcome Creatinine Nephrologist consultation Regression Analysis Female business Brazil Research Article Kidney disease |
| Zdroj: | BMC Nephrology, Vol 21, Iss 1, Pp 1-7 (2020) BMC Nephrology |
| ISSN: | 1471-2369 |
| DOI: | 10.1186/s12882-020-01751-7 |
| Popis: | Background In low-middle-income countries (LMICs), data regarding acute kidney injury (AKI) are scarce. AKI patients experience delayed diagnosis. This study aimed to evaluate whether delayed nephrologist consultation (NC) affected outcomes of AKI patients and compare Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO). Methods An observational, retrospective study was conducted in a tertiary public hospital in an LMIC. Results Overall, 103 AKI patients were analysed. In-hospital mortality was 61.16%, and dialysis was required in 38.83%. NC took place after 48 h in 68.93% of the patients. Mean time for NC was 5.22 ± 4.30 days. At NC, serum creatinine was 4.48 (±3.40) mg/dL and blood urea nitrogen was 68.21 (± 35.02) mg/dL. The AKIN and KDIGO stage stratifications were identical; KDIGO stage 3 was seen in 58.25% of the patients. The group with NC > 4 days had a mortality rate of 74.46% and the group with NC ≤ 4 days had a mortality rate of 50% (p = 0.011). Multivariate analysis showed that haemodialysis was independently associated with mortality. NC > 4 days was associated with death [odds ratio 2.66 (95% confidence interval, 1.36–4.35), p = 0.001]. Logistic regression showed an OR of 1.20 (95% CI, 1.05–1.37) (p = 0.008) for each day of delayed NC. Conclusion Delayed NC was associated with mortality even after adjustments, as was haemodialysis, though marginally. In AKI patients with NC > 4 days, there was a high prevalence of KDIGO stage 3, and AKIN and KDIGO criteria were identical. |
| Databáze: | OpenAIRE |
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