title: CLINICAL CHARACTERISTICS, OUTCOMES AND RISK FACTORS FOR DEATH AMONG CRITICALLY ILL PATIENTS WITH HIV-RELATED ACUTE KIDNEY INJURY.
abstract: The aim of this study is to describe clinical characteristics, outcomes and risk factors for death among patients with HIV-related acute kidney injury (AKI) admitted to an intensive care unit (ICU).
  
  
  
  A retrospective study was conducted with HIV-infected AKI patients admitted to the ICU of an infectious diseases hospital in Fortaleza, Brazil. All the patients with confirmed diagnosis of HIV and AKI admitted from January 2004 to December 2011 were included. A comparison between survivors and non-survivors was performed. Risk factors for death were investigated.
  
  
  
  Among 256 AKI patients admitted to the ICU in the study period, 73 were identified as HIV-infected, with a predominance of male patients (83.6%), and the mean age was 41.2 ± 10.4 years. Non-survivor patients presented higher APACHE II scores (61.4 ± 19 vs. 38.6 ± 18, p = 0.004), used more vasoconstrictors (70.9 vs. 37.5%, p = 0.02) and needed more mechanical ventilation - MV (81.1 vs. 35.3%, p = 0.001). There were 55 deaths (75.3%), most of them (53.4%) due to septic shock. Independent risk factors for mortality were septic shock (OR = 14.2, 95% CI = 2.0-96.9, p = 0.007) and respiratory insufficiency with need of MV (OR = 27.6, 95% CI = 5.0-153.0, p < 0.001).
  
  
  
  Non-survivor HIV-infected patients with AKI admitted to the ICU presented higher severity APACHE II scores, more respiratory damage and hemodynamic impairment than survivors. Septic shock and respiratory insufficiency were independently associated to death.
authors.affiliation: Federal University of Ceará, School of Medicine, Division of Nephrology, Department of Internal Medicine. Fortaleza, CE, Brazil. E-mails: leonardo.luna@hotmail.com; douglas.sousa.soares@gmail.com; lara.raissa@gmail.com; ef.daher@uol.com.br.
authors.forename: Leonardo Duarte Sobreira
authors.initials: LD
authors.lastname: Luna
authors.affiliation: Federal University of Ceará, School of Medicine, Division of Nephrology, Department of Internal Medicine. Fortaleza, CE, Brazil. E-mails: leonardo.luna@hotmail.com; douglas.sousa.soares@gmail.com; lara.raissa@gmail.com; ef.daher@uol.com.br.
authors.forename: Douglas de Sousa
authors.initials: Dde S
authors.lastname: Soares
authors.affiliation: University of Fortaleza, School of Medicine, Public Health Graduate Program. Fortaleza, CE, Brazil. E-mails: geraldobezerrajr@yahoo.com.br; eanes@fortalnet.com.br; ef.daher@uol.com.br.
authors.forename: Geraldo Bezerra da Silva
authors.initials: GB
authors.lastname: Junior
authors.affiliation: Federal University of Ceará, School of Medicine, Medical Sciences and Pharmacology Graduate Program. Fortaleza, CE, Brazil. E-mails: malenagadelha@hotmail.com; gdayllon@yahoo.com.br.
authors.forename: Malena Gadelha
authors.initials: MG
authors.lastname: Cavalcante
authors.affiliation: Federal University of Ceará, School of Medicine, Division of Nephrology, Department of Internal Medicine. Fortaleza, CE, Brazil. E-mails: leonardo.luna@hotmail.com; douglas.sousa.soares@gmail.com; lara.raissa@gmail.com; ef.daher@uol.com.br.
authors.forename: Lara Raissa Cavalcante
authors.initials: LR
authors.lastname: Malveira
authors.affiliation: Federal University of Ceará, School of Medicine, Medical Sciences and Pharmacology Graduate Program. Fortaleza, CE, Brazil. E-mails: malenagadelha@hotmail.com; gdayllon@yahoo.com.br.
authors.forename: Gdayllon Cavalcante
authors.initials: GC
authors.lastname: Meneses
authors.affiliation: University of Fortaleza, School of Medicine, Public Health Graduate Program. Fortaleza, CE, Brazil. E-mails: geraldobezerrajr@yahoo.com.br; eanes@fortalnet.com.br; ef.daher@uol.com.br.
authors.forename: Eanes Delgado Barros
authors.initials: ED
authors.lastname: Pereira
authors.affiliation: Federal University of Ceará, School of Medicine, Division of Nephrology, Department of Internal Medicine. Fortaleza, CE, Brazil. E-mails: leonardo.luna@hotmail.com; douglas.sousa.soares@gmail.com; lara.raissa@gmail.com; ef.daher@uol.com.br.|University of Fortaleza, School of Medicine, Public Health Graduate Program. Fortaleza, CE, Brazil. E-mails: geraldobezerrajr@yahoo.com.br; eanes@fortalnet.com.br; ef.daher@uol.com.br.
authors.forename: Elizabeth De Francesco
authors.initials: Ede F
authors.lastname: Daher
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D000328:Adult; D002423:Cause of Death; D016638:Critical Illness; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome