title: Risk factors of acute kidney injury requiring renal replacement therapy based on regional registry data.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a common problem in critically ill patients treated in the intensive care unit (ICU) and is associated with high mortality, particularly when renal replacement therapy (RRT) is required. Our aim was to investigate the risk factors for AKI requiring RRT (AKI-RRT).
  
  
  METHODS
  In our retrospective, multi-centre, observational study, we analysed 14,672 consecutive AKI-RRT patients hospitalized in ICUs in the Silesian Region (Poland) between October 2011 and December 2014. Demographic and clinical data were derived from the Silesian Registry of Anaesthesiology and Intensive Care Departments. Logistic regression was used to select final risk factors for AKI-RRT. The ROC method was used to analyse the value of clinical parameters to predict the risk of AKI-RRT.
  
  
  RESULTS
  Of a total of 14,672 patients, 1,234 (8.4%) developed AKI requiring RRT. Overall 59% of patients were males and the median age in the group was 66 (IQR 55-76) years. There were 16 variables that modified the risk of AKI-RRT. The AUROC for the test scored 0.845 (95% CI: 0.84-0.85; P < 0.0001).
  
  
  CONCLUSIONS
  We found multiple factors that modified the risk of AKI requiring RRT. Chronic kidney disease (CKD) and cardiogenic shock increased, whereas neurological disorders decreased the risk. Measures directed towards AKI prevention should be aimed specifically at patients with cardiological disorders and CKD.
authors.affiliation: Chair of Anaesthesiology, Intensive Therapy and Emergency Medicine, Medical University of Silesia in Katowice, Department of Cardiac Anaesthesia and Intensive Therapy, Silesian Centre for Heart Diseases in Zabrze, Poland. piotr.czempik@wp.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czempik
authors.forename: Daniel
authors.initials: D
authors.lastname: Cieśla
authors.forename: Piotr
authors.initials: P
authors.lastname: Knapik
authors.forename: Łukasz J
authors.initials: ŁJ
authors.lastname: Krzych
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000628:therapy*; D000367:Age Factors; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012372:ROC Curve; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000150:complications; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012770:Shock, Cardiogenic / Q000150:complications
keywords: acute kidney injury; intensive care unit; renal replacement therapy; risk factors