Assessment of the etiology of prerenal acute kidney injury and rhabdomyolysis in intensive care unit

Abstract

Background: Acute kidney injury (AKI) and rhabdomyolysis are among the prevalent etiologies of intensive care unit (ICU) admission that can be accompanied with different outcomes. In the current study, prerenal AKI and rhabdomyolysis etiology were assessed in patients admitted to ICU. Methods: This was a cross-sectional study conducted on 480 patients in ICU. Prerenal AKI, based on the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) criteria, and rhabdomyolysis were assessed among the patients. Demographic etiologies, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) criteria were assessed among the patients as well. Findings: 20.08 of patients were affected by prerenal AKI, rhabdomyolysis, or both. The most common underlying reason of prerenal azotemia was internal disease (52.9), and for rhabdomyolysis was trauma (88.1). Prerenal azotemia was significantly in association with male gender (P = 0.002), higher age (P < 0.001), diabetes mellitus (P = 0.006), hypertension (P = 0.018), and heart failure (P = 0.03). APACHE P = 0.001, odds ratio (OR) = 1.13, confidence interval (CI) of 95%: 1.05-1.22 and SOFA (P = 0.005, OR = 1.10, CI95%: 1.03-1.18) were predicting factors of mortality; APACHE was significantly stronger predicting factor (P < 0.001). Conclusion: Internal diseases were the main cause of prerenal AKI in patients in ICU, and most cases doomed to die. Male gender, higher age, and underlying diseases were significantly associated with prerenal azotemia. Regarding rhabdomyolysis, the main cause was surgery due to trauma. Most of the cases were young, and finally discharged with complete health. © 2019, Isfahan University of Medical Sciences(IUMS). All rights reserved.