title: [The challenge of acute kidney injury : Cross-sectional study on prevalence and costs in a university intensive care unit].
abstract: OBJECTIVE
  The prognosis of intensive care patients with acute kidney injury (AKI), which is associated with increased mortality is still poor. Current data on the prevalence and the resulting costs of AKI and an overview of the most common diagnoses associated with AKI in German intensive care units (ICU) are lacking.
  
  
  METHODS
  In this retrospective study all adult admissions (> 18 Jahre) in the five ICUs at the University Clinic Regensburg (in total 78 beds) from1 January 2011 to 31 December 2013 were evaluated. The ICU diagnoses commonly associated with AKI were identified using the international classification of diseases 10 (ICD 10). The length of ICU and hospital stays and AKI-associated hospital costs in the diagnosis-related groups (DRG) based reimbursement system were compared.
  
  
  RESULTS
  A total of 891 ICU patients with AKI were classified according to the ICD 10 code. Acute respiratory distress syndrome (ARDS), myocardial infarction (MI) and sepsis were the three most common ICU conditions associated with AKI. A total of 1103 patients were admitted with 1 of these 3 main diagnoses and 249 (22.6 %) of these patients developed AKI. Patients with AKI had significantly longer mean ICU and hospital stays compared to patients without AKI (18.6 vs 5.1 days and 23.8 vs. 10.4 days, respectively, p < 0.001). The presence of AKI in critically ill patients with ARDS, MI and sepsis resulted in additional costs of 2,019,120.42 € at the University Hospital of Regensburg in 2013.
  
  
  CONCLUSIONS
  Acute kidney injury in critically ill patients represents a significant medical and socioeconomic burden. Early recognition of patients at risk, coordinated research into novel interventions and establishment of the National Acute Kidney Injury Network for implementation of evidence-based therapies may be the next steps to decrease the incidence and severity of AKI and save costs for the national healthcare system.
authors.affiliation: Klinik und Poliklinik für Chirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. ivan.goecze@ukr.de.
authors.forename: I
authors.initials: I
authors.lastname: Göcze
authors.affiliation: Abteilung für Nephrologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Bergler
authors.affiliation: Unternehmensentwicklung, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: E
authors.initials: E
authors.lastname: Bossauer
authors.affiliation: Zentrum für klinische Studien, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Zeman
authors.affiliation: Klinik und Poliklinik für Chirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Thelen
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: B M
authors.initials: BM
authors.lastname: Graf
authors.affiliation: Abteilung für Nephrologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Banas
authors.affiliation: Klinik und Poliklinik für Chirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.affiliation: Unternehmensentwicklung, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Gnann
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Bein
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000628:therapy; D003430:Cross-Sectional Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Acute respiratory distress syndrome; Early diagnosis; Health care economics; Myocardial infarction; Sepsis