title: Identification of risk factors associated with acute kidney injury in patients admitted to acute medical units.
abstract: In 2009, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report identified significant deficiencies in the management of acute kidney injury (AKI) in hospitals in the UK. Many errors arose from failure to recognise patients with AKI and those at risk of developing AKI. Currently, there is no universally accepted risk factor assessment for identifying such patients on admission to acute medical units (AMUs). A multicentre prospective observational study was performed in the AMUs of 10 hospitals in England and Scotland to define the risk factors associated with AKI and to assess quality of care. Data were collected on consecutive acute medical admissions over two separate 24-h periods. Acute kidney injury was present in 55/316 (17.7%) patients, with sepsis, hypovolaemia, chronic kidney disease (CKD) and diabetes mellitus identified as the major risk factors. Deficiencies in patient care were identified, reinforcing the continuing need to improve the management of AKI.
authors.affiliation: Department of Medicine, Dumfries and Galloway Royal Infirmary, Dumfries, Scotland. sian.finlay@nhs.net
authors.forename: S
authors.initials: S
authors.lastname: Finlay
authors.forename: B
authors.initials: B
authors.lastname: Bray
authors.forename: A J
authors.initials: AJ
authors.lastname: Lewington
authors.forename: C T
authors.initials: CT
authors.lastname: Hunter-Rowe
authors.forename: A
authors.initials: A
authors.lastname: Banerjee
authors.forename: J M
authors.initials: JM
authors.lastname: Atkinson
authors.forename: M C
authors.initials: MC
authors.lastname: Jones
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000368:Aged; D016470:Bacteremia / Q000150:complications; D048909:Diabetes Complications; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D020896:Hypovolemia / Q000150:complications; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011787:Quality of Health Care; D051436:Renal Insufficiency, Chronic / Q000150:complications; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine
keywords: Acute kidney injury (AKI); acute medical units (AMUs); risk factors