Analysis of the etiologies and medications in hospital-acquired acute kidney injury Geren Thomas, Maura Hall John D. Archbold Memorial Hospital - Thomasville, GA
Background/Purpose: Acute kidney injury (AKI) is associated with increased mortality and healthcare costs. Identification of causes and risk factors is fundamental to reversing the trend of prolonged hospitalization.
Methodology: This retrospective, cross-sectional study of patients at John D. Archbold Memorial Hospital assessed causes of acute kidney injury during hospitalization. Patients were included if they were found to have a diagnosis code of N17.9, acute kidney failure unspecified, and were inpatients sometime during the 2017 calendar year. Patients were excluded if acute kidney injury was diagnosed during or prior to admission.
Results: Two-thirds of AKI cases could be attributed to pre-renal etiology. Surgical and contrast-induced nephropathy each played a role in about 25% of cases. About one-quarter of patients had multifactorial injuries. Over half of patients received a beta-lactam or cephalosporin, a loop diuretic, or a proton pump inhibitor prior to documented renal injury. Other commonly observed nephrotoxic drugs included statins, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and vancomycin.
Conclusions: The majority of AKI events not present on admission can be attributed to pre-renal causes. The high numbers of patients on loop diuretics with heart failure as a comorbidity may indicate a common cause of acute injury is over-diuresis in exacerbation of heart failure.
Presentation Objective: Communicate demographics of hospitalized patients who developed AKI and the etiologies and medications most likely associated with their renal decline.
Self-Assessment: Which of the following medications requires close surveillance of renal function due to the high number of AKI events identified in this study?
