title: Evaluation of risk factors and development of acute kidney injury in aneurysmal subarachnoid hemorrhage, head injury, and severe sepsis/septic shock patients during ICU treatment.
abstract: BACKGROUND
  There are few studies examining development of acute kidney injury (AKI) in the various types of patients in intensive care units (ICUs). Presently described is evaluation of risk factors and development of AKI in different groups of ICU patients.
  
  
  METHODS
  Present study was performed in 3 different ICUs. Development of AKI was measured using Acute Kidney Injury Network (AKIN) classification system. Total of 300 patients who were treated in trauma, neurosurgery, or general ICU departments (due to head injury, aneurysmal subarachnoid hemorrhage [aSAH], or severe sepsis/septic shock, respectively) were assessed for incidence, risk factors, and development of AKI.
  
  
  RESULTS
  AKI did not develop in aSAH patients when evaluated based on serum creatinine level; however, it was observed in 5% of aSAH patients according to volume adjusted creatinine (VACr) level. AKI developed in 76% of sepsis group, and in 20% of head injury group, based on AKIN classification, according to both serum and VACr levels. Incidence of AKI was significantly higher in sepsis group (p<0.001). Only use of vasopressor was significantly related to AKI development in sepsis and head injury groups. Mortality rate was 8%, 22%, and 42% in aSAH, head injury, and sepsis groups, respectively. AKI development and vasopressor use were significantly related to mortality in sepsis group.
  
  
  CONCLUSIONS
  Despite similar characteristics and risk factors, there were fewer instances of AKI in aSAH group. Hypertension or hydration therapy used to treat vasospasm and polyuria due to cerebral salt-wasting syndrome may prevent aSAH patients from developing AKI.
authors.forename: Ceren
authors.initials: C
authors.lastname: Kamar
authors.forename: Achmet
authors.initials: A
authors.lastname: Ali
authors.forename: Demet
authors.initials: D
authors.lastname: Altun
authors.forename: Günseli
authors.initials: G
authors.lastname: Orhun
authors.forename: Akın
authors.initials: A
authors.lastname: Sabancı
authors.forename: Altay
authors.initials: A
authors.lastname: Sencer
authors.affiliation: Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey. iozkana@gmail.com.
authors.forename: İbrahim Özkan
authors.initials: İÖ
authors.lastname: Akıncı
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000453:epidemiology; D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000453:epidemiology; D055815:Young Adult