Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients

Hyperchloremia is still the least looked at electrolytes imbalance in ICU despite a few studies in the last decade has proven its association with AKI. This study is aimed to report on the incidence and factors associated with AKI in hyperchloremic critically ill adult patients. Methods In this...

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Main Author:	Hisham, Wan Mohd Hafidz Wan
Format:	Thesis
Language:	English
Published:	2019
Subjects:	R Medicine
Online Access:	http://eprints.usm.my/53501/1/Wan%20Mohd%20Hafidz%20Wan%20Hisham-24%20pages.pdf
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spelling	my-usm-ep.535012022-07-21T03:53:30Z Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients 2019 Hisham, Wan Mohd Hafidz Wan R Medicine Hyperchloremia is still the least looked at electrolytes imbalance in ICU despite a few studies in the last decade has proven its association with AKI. This study is aimed to report on the incidence and factors associated with AKI in hyperchloremic critically ill adult patients. Methods In this retrospective cohort study held in a tertiary hospital, hyperchloremic patients aged 18-65 years old on admission were included. Development of AKI using AKIN criteria within the next 48 hours was marked as the primary outcome and factors associated with it were analysed. Results 248 (11.7%) of the patients admitted during the study were hyperchloremic on admission. Out of this, 84 (34%) patients developed AKI. Age 56-65 years [OR=2.598 (1.126-5.995); p=0.025], SAPS II score [OR=1.04 (1.02-1.06); p<0.001], respiratory failure [OR=2.516 (1.064-5.947); p=0.036], cardiovascular failure [OR=2.239 (1.083-4.626); p=0.030], severe hyperchloremia[OR=2.045 (1.176-3.557); p=0.011], severe acidemia [OR=2.733 (1.269-5.886); p=0.010] and severe metabolic acidosis[OR=2.003 (1.010-3.972);p=0.047] were found to be associated with AKI. After adjusting to confounding factors, SAPS II score (adjusted OR, 1.032 [1.003-1.062]; p=0.028) and age 56-65 years (adjusted OR, 2.506 [1.024-6.135]; p=0.044) were found to be predictive of AKI. Conclusions One-third of hyperchloremic patients developed AKI after 48 hours of ICU admission. SAPS II score and age group 55-65 years are proven to be predictive factors of later development of AKI. SAPS II score is a useful tool in predicting AKI in hyperchloremic patients. 2019 Thesis http://eprints.usm.my/53501/ http://eprints.usm.my/53501/1/Wan%20Mohd%20Hafidz%20Wan%20Hisham-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine
spellingShingle	R Medicine Hisham, Wan Mohd Hafidz Wan Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
description	Hyperchloremia is still the least looked at electrolytes imbalance in ICU despite a few studies in the last decade has proven its association with AKI. This study is aimed to report on the incidence and factors associated with AKI in hyperchloremic critically ill adult patients. Methods In this retrospective cohort study held in a tertiary hospital, hyperchloremic patients aged 18-65 years old on admission were included. Development of AKI using AKIN criteria within the next 48 hours was marked as the primary outcome and factors associated with it were analysed. Results 248 (11.7%) of the patients admitted during the study were hyperchloremic on admission. Out of this, 84 (34%) patients developed AKI. Age 56-65 years [OR=2.598 (1.126-5.995); p=0.025], SAPS II score [OR=1.04 (1.02-1.06); p<0.001], respiratory failure [OR=2.516 (1.064-5.947); p=0.036], cardiovascular failure [OR=2.239 (1.083-4.626); p=0.030], severe hyperchloremia[OR=2.045 (1.176-3.557); p=0.011], severe acidemia [OR=2.733 (1.269-5.886); p=0.010] and severe metabolic acidosis[OR=2.003 (1.010-3.972);p=0.047] were found to be associated with AKI. After adjusting to confounding factors, SAPS II score (adjusted OR, 1.032 [1.003-1.062]; p=0.028) and age 56-65 years (adjusted OR, 2.506 [1.024-6.135]; p=0.044) were found to be predictive of AKI. Conclusions One-third of hyperchloremic patients developed AKI after 48 hours of ICU admission. SAPS II score and age group 55-65 years are proven to be predictive factors of later development of AKI. SAPS II score is a useful tool in predicting AKI in hyperchloremic patients.
format	Thesis
qualification_level	Master's degree
author	Hisham, Wan Mohd Hafidz Wan
author_facet	Hisham, Wan Mohd Hafidz Wan
author_sort	Hisham, Wan Mohd Hafidz Wan
title	Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
title_short	Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
title_full	Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
title_fullStr	Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
title_full_unstemmed	Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients
title_sort	incidence and factors associated with acute kidney injury (aki) in hyperchloremic critically iii adult patients
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2019
url	http://eprints.usm.my/53501/1/Wan%20Mohd%20Hafidz%20Wan%20Hisham-24%20pages.pdf
_version_	1747822247147470848

Incidence and factors associated with acute kidney injury (AKI) in hyperchloremic critically III adult patients

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