Epidemiology of Acute Kidney Injury in Moroccan Medical Intensive Care Patients: A Regional Prospective, Observational Study

Objective: To evaluate the incidence, mortality and influencing factors for the development of Acute Kidney Injury (AKI) at admission or during Intensive Care Unit (ICU) stay. Methods: We conducted a prospective, epidemiological survey, in ICU for two years and the data of 97 patients admitted to ICU for medical illness was analyzed. Patients with AKI were categorized by serum creatinine and urine output into 3 stages. Stage 1 was defined as an absolute increase (within 48 hours) in serum creatinine of more than or equal to 0.3 mg/dl, or oliguria of less than 0.5ml/kg per hour for more than six hours. Stage 2 was defined as doubling of serum creatinine, or a urinary output lower than 0.5ml/kg /h for 12 h. Stage 3 was defined as tripling of serum creatinine or a urinary output lower than 0.3 ml/kg/h for 24 h, or anuria for 12 h. Results: Sixty patients ( 62 %) had AKI. AKI patients tended to be older and usually had antecedent of heart disease, a high Simplified Acute Physiology Score version II at admission, more use of mechanical ventilation and vasopressor treatment, more shock, more severe sepsis, more hyperosmolar hyperglycemic state (HHS) and higher mortality. In multivariate analysis, SAPS II score >30, antecedent of heart disease and shock were independent risk factors for development of AKI at admission or during ICU stay. Conclusion: AKI had a high incidence and a high mortality in medical ICU’s patients. Antecedent of severe underlying diseases, heart disease and hemodynamic failure were independent risk factors of AKI.