The epidemiology of acute kidney injury in critically ill patients in
the Gansu Province: the EACG Study
Abstract
Objective: To investigate the epidemiology of acute kidney injury and to
clarify the risk factors associated with the prognosis of acute kidney
injury in critically ill patients in the Gansu Province.Methods: This
was a multicenter, retrospective study. The clinical data of all
patients from January 1, 2017, to December 31, 2019, in the intensive
care unit of the selected hospitals were screened. Descriptive
statistical analysis was performed first, and then the patients were
divided into a survival group and a nonsurvival group based on survival
status at discharge. RESULTS: (1) Among the 8106 patients admitted, a
total of 3019 patients were excluded according to the exclusion
criteria. Among the included patients, 890 patients met the diagnostic
criteria for AKI, with an incidence of 17.5% and mortality of 41.3%.
Among the selected AKI patients, AKI stage I accounted for 22.02%, AKI
stage II accounted for 31.01%, AKI stage III accounted for 46.97%, and
35.8% of the AKI patients received renal replacement therapy. The
higher the AKI stage was, the higher the percentage of renal replacement
therapy use. (2) Logistic regression analysis showed that sex, age, AKI
stage, RRT, infection, cardio-pulmonary resuscitation, cardiac output,
mechanical ventilation, diuretics, white blood cells, platelets, blood
urea nitrogen, prothrombin time and activated partial thromboplastin
time were significantly associated with the prognosis of acute kidney
injury (P <0.05). Further analysis showed that male sex, old
age, high AKI stage, RRT treatment, low cardiac output, mechanical
ventilation, elevated leukocyte count, reduced platelet count and
reduced serum albumin were independent risk factors for a poor prognosis
of AKI. Conclusions: Data from several representative general hospitals
in the Gansu Province showed that the incidence and mortality of acute
kidney injury in intensive care units were still very high. Sepsis and
septic shock are the main causes of AKI.