title: Incidence, risk factors and 90-day mortality of patients with acute kidney injury in Finnish intensive care units: the FINNAKI study.
abstract: OBJECTIVE
  We aimed to determine the incidence, risk factors and outcome of acute kidney injury (AKI) in Finnish ICUs.
  
  
  METHODS
  This prospective, observational, multi-centre study comprised adult emergency admissions and elective patients whose stay exceeded 24 h during a 5-month period in 17 Finnish ICUs. We defined AKI first by the Acute Kidney Injury Network (AKIN) criteria supplemented with a baseline creatinine and second with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We screened the patients' AKI status and risk factors for up to 5 days.
  
  
  RESULTS
  We included 2,901 patients. The incidence (95 % confidence interval) of AKI was 39.3 % (37.5-41.1 %). The incidence was 17.2 % (15.8-18.6 %) for stage 1, 8.0 % (7.0-9.0 %) for stage 2 and 14.1 % (12.8-15.4 %) for stage 3 AKI. Of the 2,901 patients 296 [10.2 % (9.1-11.3 %)] received renal replacement therapy. We received an identical classification with the new KDIGO criteria. The population-based incidence (95 % CI) of ICU-treated AKI was 746 (717-774) per million population per year (reference population: 3,671,143, i.e. 85 % of the Finnish adult population). In logistic regression, pre-ICU hypovolaemia, diuretics, colloids and chronic kidney disease were independent risk factors for AKI. Hospital mortality (95 % CI) for AKI patients was 25.6 % (23.0-28.2 %) and the 90-day mortality for AKI patients was 33.7 % (30.9-36.5 %). All AKIN stages were independently associated with 90-day mortality.
  
  
  CONCLUSIONS
  The incidence of AKI in the critically ill in Finland was comparable to previous large multi-centre ICU studies. Hospital mortality (26 %) in AKI patients appeared comparable to or lower than in other studies.
authors.affiliation: Division of Anaesthesia and Intensive Care Medicine Department of Surgery, Intensive Care Units, Helsinki University Central Hospital, Box 340, 00029 HUS Helsinki, Finland. sara.nisula@hus.fi
authors.forename: Sara
authors.initials: S
authors.lastname: Nisula
authors.forename: Kirsi-Maija
authors.initials: KM
authors.lastname: Kaukonen
authors.forename: Suvi T
authors.initials: ST
authors.lastname: Vaara
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Korhonen
authors.forename: Meri
authors.initials: M
authors.lastname: Poukkanen
authors.forename: Sari
authors.initials: S
authors.lastname: Karlsson
authors.forename: Mikko
authors.initials: M
authors.lastname: Haapio
authors.forename: Outi
authors.initials: O
authors.lastname: Inkinen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Parviainen
authors.forename: Raili
authors.initials: R
authors.lastname: Suojaranta-Ylinen
authors.forename: Jouko J
authors.initials: JJ
authors.lastname: Laurila
authors.forename: Jyrki
authors.initials: J
authors.lastname: Tenhunen
authors.forename: Matti
authors.initials: M
authors.lastname: Reinikainen
authors.forename: Tero
authors.initials: T
authors.lastname: Ala-Kokko
authors.forename: Esko
authors.initials: E
authors.lastname: Ruokonen
authors.forename: Anne
authors.initials: A
authors.lastname: Kuitunen
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors