Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study

We analysed the demographic, morbidity, treatment modality and outcome data of patients (n = 459) admitted to ICUs between October 1st, 2009 and November 30th, 2009 using a prospectively filled in electronic survey form in 7 representative ICUs.The major reason for ICU admission was surgical in 64.3% of patients and medical in the remaining 35.7%. One-hundred-twelve patients (24.4%) had AKI. By AKIN criteria 11.5% had Stage 1, 5.4% had Stage 2 and 7.4% had Stage 3. In 44.0% of patients, AKI was associated with septic shock. Vasopressor treatment, SAPS II score, serum creatinine on ICU admission and sepsis were the independent risk factors for development of any stage of AKI. Among the Stage 3 patients (34) 50% received renal replacement therapy. The overall utilization of intermittent renal replacement therapy was high (64.8%). The overall in-hospital mortality rate of AKI was 49% (55/112). The ICU mortality rate was 39.3% (44/112). The independent risk factors for ICU mortality were age, mechanical ventilation, SOFA score and AKI Stage 3.For the first time we have established the incidence of AKI using the AKIN criteria in Hungarian ICUs. Results of the present study confirm that AKI has a high incidence and is associated with high ICU and in-hospital mortality.Despite improvements in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise during hospital admission [1-3]. AKI has been the focus of numerous publications and research projects in the past 5 years. The incidence of AKI (during hospital admission) ranges from 3 to 25% depending on criteria applied. The variety of definitions used in clinical studies may be partially responsible for the large variations in the reported incidence and the associated mortality (19-83%) of AKI [4-7]. Today the two widely accepted classification systems are the RIFLE criteria [8,9] and the staging system for AKI as established by Acute Dialysis Quality Initiative (ADQI) and the