INCIDENCE AND ETIOLOGY OF ACUTE KIDNEY INJURY IN HOSPITALIZED PATIENTS IN DEPARTMENT OF MEDICINE, PRANANGKLAO HOSPITAL

Abstract

Acute kidney injury (AKI) is a common problem in hospitalized patients and affects to increased morbidity, mortality, cost, and length of hospitalization. This prospective study aims to examine the incidence of AKI according to the 2012 Kidney Disease Improving Global Outcome (KDIGO) criteria including etiology of AKI among hospitalized patients aged more than 18 years old in Department of Medicine, Pranangklao Hospital, during 1 July- 31 December 2019. Data were collected by questionnaires and medical record reviews, were calculated for incidence and etiology of AKI, and were analyzed by descriptive analytics, chi-square test, and independent t-test. The result showed that 3,428 hospitalized patients in Department of Medicine, the incidence of AKI was 32.2%. The majority of AKI was diagnosed by serum creatinine criteria (96.8%). And 3.2% of AKI was diagnosed by urine output criteria. According to the 2012 KDIGO, there were AKI stage 1 in 18.1%, stage 2 in 21.7%, and stage 3 in 60.2%. The etiologies of AKI were mainly from sepsis/infection (44.4), dehydration (22.2), and cardiorenal syndrome (10.4). Renal replacement therapy occurred 19.5%. Mortality rate of the patients with AKI was 21.9%. Age more than 60 years and KDIGO stage of AKI were the independent risk factor of in-hospital mortality in the patient with AKI. In conclusion, AKI is commonly found about 1 in 3 of the hospitalized patients in Department of Medicine, Pranangklao Hospital. Infection, dehydration, and cardiorenal syndrome were the major causes of AKI.