title: Acute kidney injury in an infectious disease intensive care unit - an assessment of prognostic factors.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common complication in many infectious diseases. There are few studies to investigate risk factors for death in infectious diseases-associated AKI.
  
  
  METHODS
  This is a retrospective study including all patients with acute kidney injury (AKI) admitted to an infectious diseases intensive care unit (ICU) in Brazil between October 2003 and September 2006.
  
  
  RESULTS
  A total of 722 patients were admitted to the infectious disease ICU in the study period. AKI occurred in 147 cases (17.7%). The mean age was 45 +/- 5.6 years, and 77% were male. The mean length of hospital stay was 11.5 +/- 10.3 days. The main causes of ICU hospitalization were acquired immunodeficiency syndrome (AIDS)-related diseases (28 .6%), pneumonia 13%), leptospirosis (11.6%), meningitis (8.2%), disseminated histoplasmosis (6.8%) and tetanus (5.4%). The main cause of AKI was sepsis (41.5%). Patients were classified according to RIFLE as "Risk" (5.6%), "Injury" (21.7%) and "Failure" (72.7%). Patients in "Failure" showed a higher mortality (p = 0.007). Multivariate analysis showed that dependent risk factors for death were oliguria (OR = 5.59, P = 0.002), metabolic acidosis (OR = 5.13, P = 0.01), sepsis (OR = 4.79, P = 0.001), hypovolaemia (OR = 4.11, P = 0.01), use of vasoactive drugs (OR = 3.34, P = 0.02), use of mechanical ventilation (OR = 2.94, P = 0.03) and high APACHE II score (OR = 1.14, P = 0.001).
  
  
  CONCLUSIONS
  There are important risk factors for death among critically ill patients with infectious diseases associated with AKI.
authors.affiliation: Department of Internal Medicine, Faculdade de Medicina, Hospital Universitario Walter Cantidio, Unversidade Federal do Ceara, Fortaleza, Ceará, Brazil. ef.daher@uol.com.br
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
authors.forename: Cristina N
authors.initials: CN
authors.lastname: Marques
authors.forename: Rafael S A
authors.initials: RS
authors.lastname: Lima
authors.forename: Geraldo B
authors.initials: GB
authors.lastname: Silva Júnior
authors.forename: Aline S
authors.initials: AS
authors.lastname: Barbosa
authors.forename: Eveline S
authors.initials: ES
authors.lastname: Barbosa
authors.forename: Rosa M S
authors.initials: RM
authors.lastname: Mota
authors.forename: Sônia
authors.initials: S
authors.lastname: Leite da Silva
authors.forename: Sônia M H A
authors.initials: SM
authors.lastname: Araújo
authors.forename: Alexandre B
authors.initials: AB
authors.lastname: Libório
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003141:Communicable Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors