Akut Böbrek Hasarı Nedeni ile Acil Servise Başvuran Hastaların Klinik ve Demografik Özelliklerinin İncelenmesi
Özet
Acute kidney
injury (AKI) is a common disorder with increasing frequency in years which is directly
related to high mortality, morbidity, long hospitalization and increased cost. However,
literature about AKI in emergency department is limited. AKI was detected in 166
patients (0.7% of all applications) who admitted to Hacettepe University Adult
Emergency Department between 1st May 2011 and 30th April 2012. The mean (range)
age was 67 (21-93) years and gender difference wasn‘t seen. 37.4% of patients used
ambulance. 14.4% of patients applied with the AKI-unrelated symptoms. Applications
in summer were three times more than the ones in winter. MAP<70mmHg,
hypertension, cancer, coronary artery disease, diabetes mellitus, congestive heart
failure, chronic kidney disease, chronic obstructive pulmonary disease, neurologic and psychological diseases, nephrotoxic medicine and contrast usage were seen in higher
rates in patients with AKI. According to RIFLE criteria, injury in kidney was classified
as risk in 49.4%, injury in 32.5% and failure in18.1%. AKI was caused by 89.8% prerenal,
4.2% renal and 6% post-renal; IV hydration was applied on 87.3% of patients.
15.1% of patients received dialysis treatment. 60.2% of them recovered, 39.8% of the
patients died. AKI was cured completely in 49% and partially in 19.9%. Recovery
wasn’t seen in 30.7% of the patients and 26.5% of them died. The rate of kidney
functions failure to recover was significantly higher in patients diagnosed with sepsis,
pneumonia and receiving dialysis treatment. The frequency of AKI occurrence will
increase along with the world population who gets older and has increasing number of
chronic disease. According to Kidney Disease Improving Global Outcomes data, the
failure of doctors to recognize AKI and give the required importance is in question. AKI
seen in emergency departments as different from the ones at hospital is highly related to
pre-renal reasons and the rate of injury is less. With suitable hydration in patients, high
level of recovery is seen.