Akut Böbrek Hasarı Nedeni ile Acil Servise Başvuran Hastaların Klinik ve Demografik Özelliklerinin İncelenmesi

Abstract

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.