title: Acute kidney injury in a Malaysian intensive care unit: Assessment of incidence, risk factors, and outcome.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. We aim to assess its incidence using both urine output and creatinine criteria and its association with risk factors and outcome.
  
  
  METHODS
  This was a single-center, prospective, observational study. All intensive care unit (ICU) patients older than 18 years were screened for inclusion in the study. Admission of less than 48 hours, postelective surgery, and ICU readmission were excluded.
  
  
  RESULTS
  A total of 143 patients were recruited, of these, 65% had AKI, of which 18 (19%) were stage 1; 23 (25%), stage 2; and 52 (56%), stage 3. Independent risk factors for AKI include high Acute Physiology and Chronic Health Evaluation II score and septic shock (odds ratio of 1.20 [1.09-1.33] and 8.41 [1.49-47.6], respectively). Thirty-eight percent were classified as AKI based on creatinine and 61% as AKI based on urine output criteria, and, in 34%, both AKI based on creatinine and AKI based on urine output criteria were present. Acute kidney injury was an independent risk factor for mortality (hazard ratio of, 2.61 [1.06-6.42]).
  
  
  CONCLUSIONS
  Acute kidney injury is common in our ICU, and almost half are of highest severity stage. Patients with high severity of illness and septic shock were at risk for AKI. The presence of AKI independently predicted mortality.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia, Jalan Hospital Campus, Kuantan, Pahang, Malaysia 25000. Electronic address: drazrina@gmail.com.
authors.forename: Azrina
authors.initials: A
authors.lastname: Md Ralib
authors.affiliation: Department of Anaesthesiology and Intensive Care, Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia, Jalan Hospital Campus, Kuantan, Pahang, Malaysia 25000. Electronic address: basri.matnor@gmail.com.
authors.forename: Mohd Basri
authors.initials: MB
authors.lastname: Mat Nor
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors; D014556:Urine
chemical_list: D003404:Creatinine
keywords: Acute kidney injury; Dialysis; Epidemiology; Intensive care unit; Mortality; Risk factors