title: Epidemiology of acute kidney injury in Hungarian intensive care units: a multicenter, prospective, observational study.
abstract: BACKGROUND
  Despite the substantial progress in the quality of critical care, the incidence and mortality of acute kidney injury (AKI) continues to rise during hospital admissions. We conducted a national, multicenter, prospective, epidemiological survey to evaluate the importance of AKI in intensive care units (ICUs) in Hungary. The objectives of this study were to determine the incidence of AKI in ICU patients; to characterize the differences in aetiology, illness severity and clinical practice; and to determine the influencing factors of the development of AKI and the patients' outcomes.
  
  
  METHODS
  We analysed the demographic, morbidity, treatment modality and outcome data of patients (n = 459) admitted to ICUs between October 1st, 2009 and November 30th, 2009 using a prospectively filled in electronic survey form in 7 representative ICUs.
  
  
  RESULTS
  The major reason for ICU admission was surgical in 64.3% of patients and medical in the remaining 35.7%. One-hundred-twelve patients (24.4%) had AKI. By AKIN criteria 11.5% had Stage 1, 5.4% had Stage 2 and 7.4% had Stage 3. In 44.0% of patients, AKI was associated with septic shock. Vasopressor treatment, SAPS II score, serum creatinine on ICU admission and sepsis were the independent risk factors for development of any stage of AKI. Among the Stage 3 patients (34) 50% received renal replacement therapy. The overall utilization of intermittent renal replacement therapy was high (64.8%). The overall in-hospital mortality rate of AKI was 49% (55/112). The ICU mortality rate was 39.3% (44/112). The independent risk factors for ICU mortality were age, mechanical ventilation, SOFA score and AKI Stage 3.
  
  
  CONCLUSIONS
  For the first time we have established the incidence of AKI using the AKIN criteria in Hungarian ICUs. Results of the present study confirm that AKI has a high incidence and is associated with high ICU and in-hospital mortality.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Dr. Kenessey Albert Hospital, Rakoczi ut 125-127, Balassagyarmat, 2660, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Medve
authors.forename: Csaba
authors.initials: C
authors.lastname: Antek
authors.forename: Balazs
authors.initials: B
authors.lastname: Paloczi
authors.forename: Szilvia
authors.initials: S
authors.lastname: Kocsi
authors.forename: Bela
authors.initials: B
authors.lastname: Gartner
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Marjanek
authors.forename: Gabor
authors.initials: G
authors.lastname: Bencsik
authors.forename: Peter
authors.initials: P
authors.lastname: Kanizsai
authors.forename: Tibor
authors.initials: T
authors.lastname: Gondos
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome