Abstract
Objetive: To establish the association of acute renal failure with demographic and clinical factors in patients hospitalized in an intensive care unit in a Colombian city.
Methods: Analytical case-control study whose source of information was the patient´s clinical history, in a sample of 130 cases and 184 controls; the cases were about patients older than 18 years, who had a glomerular filtration rate higher than 60 ml / min and who were able to fulfilled the AKIN criteria. With the independence test, it was established the effect of the factors of interest on the result (case-control), with the Odds Ratio (OR) as a measure of the association with its 95% confidence interval. The logistic regression allowed to control the presumable variables of confusion.
Results: The average age of patients was 62.2 years (SD-16.7 years) with a predominance of men from the urban area and where hypertension stood out in 52.2% of them. On admission, 55.7% had coronary syndrome and 40% developed acute renal failure (ARF); 84.6% of the patients were stage according to the AKIN classification. The administration of saline in the first 24 hours of admission increased the possibility of ARF 1.8 times compared to those administered with Ringer´s lactate (OR 1.8 CI (95% OR: 1.2-2.8), adjusting for other variables.
Conclusion: The administration of ringer´s lactate decreases the development of acute renal failure; also, age of the patient and if it came from the postoperative period, were the factors that were related to the presence of kidney disease.
References
Monedero P, García-Fernández N, Pérez-Valdivieso JR, Vives M, Lavilla J. Insuficiencia renal aguda. Rev Esp Anestesiol Reanim. 2011;58(6):335-402.
Palacio Pérez H, Puga Torres MS, García Valdés R, Mezquia de Pedro N. Insuficiencia renal aguda en el paciente críiticamente enfermo. Rev Cub Med Mil. 2007;36(2):1-7.
Asociación Colombiana de Medicina Crítica y Cuidado Intensivo, Asociación Colombiana de Nefrología e Hipertensión Arterial. Primer consenso colombiano en lesión renal aguda. Acta Colombiana de Cuidado Intensivo. 2011;11(4):65-147.
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest. 1992;101(6):1644-55. http://dx.doi.org/10.1378/chest.101. 6.1644
Marin JM, Carrizo SJ, Gascon M, Sanchez A, Gallego B, Celli BR. Inspiratory capacity, dynamic hyperinflation, brethlessnee, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;163(6):1395-9. http://dx.doi.org/10.1164/ajrccm.163.6.2203172
Machin D, Campbell MJ, Fayers PM, Pinol A. Sample size tables for clinical studies. 2ª ed. Wiley; 1997.
Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813-8. http://dx.doi.org/10.1001/jama.294.7.813
Tejara D, Varela F, Acosta D, Figueroa S, Benencio S, Verdaguer C et al. Epidemiología de la injuria renal aguda y enfermedad renal crónica en la unidad de cuidados intensivos. Rev Bras Ter Intensiva. 2017;29(4):444-452. http://dx.doi.org/10.5935/0103-507X.20170061
Díaz de León Ponce MA, Briones Garduño JC, Aristondo Magaña G. Clasificaciones de la insuficiencia renal aguda. Rev Asoc Mex Med Crit y Ter Int. 2014;28(1):28-31.
Self WH, Semler MW, Wanderer JP, Wang L, Byrne DW, Collins SP et al. Balanced crystalloids versus saline in noncritically ill adults. N Engl J Med. 2018;378(9):819-828. http://dx.doi.org/10.1056/NEJMoa1711586
Zampieri FG, Ranzani OT, Azevedo LC, Martins ID, Kellum JA, Libório AB. Lactated ringer is associated with reduced mortality and less acute kidney injury in critically ill patients: a retrospective cohort analysis. Crit Care Med. 2016;44(12):2163-2170. http://dx.doi.org/10.1097/CCM.0000000000001948
Raghunathan K, Shaw A, Nathanson B, Stürmer T, Brookhart A, Stefan MS et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med. 2014;42(7):1585-91.