Study on occurrence of Acute kidney injury in poisoned patient admitted in ICU during one year

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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TOXICOLOGY15_179

تاریخ نمایه سازی: 15 بهمن 1398

Abstract:

Introduction: Acute kidney injury (AKI) refers to an abrupt decrease in kidney function, resulting in retention of urea and other nitrogenous waste products. Using AKIN and FIFLE criteria we evaluated occurrence and staging of AKI in critically ill poisoned patients admitted in ICU during one year in the current study. Method: Retrospective study data were collected from records of 146 patients admitted in ICU, Emam Reza Hospital from March 2017 to March 2018. This hospital is a tertiary care center for poisoning in the metropolitan city of Mashhad, Khorasan Razavi. All patients included the study are above 18 years old without a history of renal dysfunction , ESRD and kidney transplantation .Demographic information including primary diagnosis, comorbid disease, laboratory tests on arrival, Urea and Creatinin(Cr) of serum( once admission and then every 48 hours), need to hemodialysis, length of hospitalization stay in ICU and outcome were recorded for all patients. We considered baseline serum Cr more than 1mg/dL for female and above 1.3mg/dL for men. Data were analyzed by SPSS software. Results: 146 cases of poisoning with different drugs, pesticides and illegal substances were included in the study period. Opioids, Organophosphates, Aluminium Phosphide, Multiple drugs and miscellaneous poisoning were the main 5 poisoning classes. The largest group was an Opioid toxicity class with 51 patients; cases in this group experienced longer length of hospitalization stay (LOS) and serum Cr level. Among all 146 patients, 13% died during the acute phase, 4.1% were discharged with consent, and 66% were transferred to the ward. Renal replacement therapy was required in 24 cases (16.4). Of all cases, 18(12.3%) patients had renal dysfunction (6 patients at risk, 5 patient injury and 7 patients were failure based on RIFLE criteria. Conclusion: Occurrence of AKI based on RIFLE criteria was not correlated with outcome of patients in the current study. A significant difference was detected in term of LOS between 5 patients groups. (PV =0.019). Comparison of the prevalence of AKI in 5 main common types of intoxication can be discussed separately; it is unlikely that there will be a significant difference in occurrence of AKI between these main classes. Opioid poisoning was the largest group of intoxicated patients admitted in ICU and had the highest rate of AKI too.

Authors

Roghaye Rashidi

Medical toxicology center, Mashhad University of Medical Science, Mashhad, Iran

Vahide Mohamadzadeh

Medical toxicology center, Mashhad University of Medical Science, Mashhad, Iran

Nasrin Milani

Community Medicine, Mashhad University of Medical Science, Mashhad, Iran

Lida Jarahi

Department of Internal medicine, Mashhad University of Medical Science, Mashhad, Iran

Bita Dadpour

Department of Clinical Toxicology, Imam Reza Hospital, Medical toxicology center, Mashhad University of Medical Science, Mashhad, Iran