title: Prevalence of acute kidney injury in intensive care units: the "COrte de prevalencia de disFunción RenAl y DEpuración en críticos" point-prevalence multicenter study.
abstract: OBJECTIVE
  This study aimed to measure the point prevalence of kidney dysfunction (KD) in the intensive care setting.
  
  
  METHODS
  A point-prevalence, single-day, prospective study was conducted. Of 919 patients present in 42 Intensive care units (ICUs) for 2 specific days (September 2009 and March 2010), 832 cases were included. Mild KD was defined as a measured creatinine clearance of 90 to 60 mL min(-1) 1.73 m(-2), and severe KD was defined as a creatinine clearance less than 60 mL min(-1) 1.73 m(-2).
  
  
  RESULTS
  Prevalence of mild KD was 15.9/100 patients/d (13.5-18.5), and severe KD was 42.4/100 patients/d (39.1-45.8). We considered as having a low probability of experiencing KD those patients without chronic kidney disease, acute kidney injury network stage 0, and a serum creatinine less than 1.2 mg/dL, but among them (557 patients), 18.1% (15.2%-21.6%) had mild KD and 24.2% (20.9%-28%) had severe KD. ICU mortality was 10.6% (7.81%-14.4%) for patients without dysfunction, 16.6% (11.2%-24%) for patients with mild KD, and 29.7% (25.2%-34.7%; P<.001) for patients with severe KD, with a relative risk for severe KD vs no KD of 2.54 (1.90-3.40). In 54.3% patients, at least 1 renal insult was reported. One nephrotoxic drug was administered to 34.4% and 2 or more to 14.9% patients, with a lower frequency among those with chronic kidney disease (30.6% vs 50.8%; P<.05).
  
  
  CONCLUSIONS
  Each day of study, more that half of the patients admitted to the ICU showed some derangement in kidney function. More than 25% of patients not fulfilling the KD criteria by serum creatinine or acute kidney injury network showed, in fact, a severe KD, and this finding was associated with higher mortality. More than 50% of the patients admitted to the ICU were subjected to at least 1 renal insult.
authors.affiliation: University of Malaga Medical School, Málaga, Spain; ICU, University Hospital Carlos Haya, Málaga, Spain. Electronic address: mehguci@gmail.com.
authors.forename: Manuel E
authors.initials: ME
authors.lastname: Herrera-Gutiérrez
authors.forename: Gemma
authors.initials: G
authors.lastname: Seller-Pérez
authors.forename: José A
authors.initials: JA
authors.lastname: Sánchez-Izquierdo-Riera
authors.forename: Javier
authors.initials: J
authors.lastname: Maynar-Moliner
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology
keywords: Creatinine clearance; Kidney dysfunction; Kidney injury acute; Nephrotoxics; Outcome measures; Prevalence studies