Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit
Abstract Background Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16–25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-02-01
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| Series: | Annals of Intensive Care |
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| Online Access: | http://link.springer.com/article/10.1186/s13613-018-0373-y |
| _version_ | 1818332635093532672 |
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| author | Dana Y. Fuhrman Sandra Kane-Gill Stuart L. Goldstein Priyanka Priyanka John A. Kellum |
| author_facet | Dana Y. Fuhrman Sandra Kane-Gill Stuart L. Goldstein Priyanka Priyanka John A. Kellum |
| author_sort | Dana Y. Fuhrman |
| collection | DOAJ |
| description | Abstract Background Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16–25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16–55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality. Results AKI developed in 52.6% (n = 8270) of the entire cohort and in 39.8% of the young adult age group (16–25 years). The AUCs for the age categories were similar at 0.754, 0.769, 0.772, and 0.770 for the 16–25-, 26–35-, 36–45-, and 45–55-year age groups, respectively. For the youngest age group, diabetes (OR 1.89; 95% CI 1.09–3.29), surgical reason for admission (OR 1.79; 95% CI 1.44–2.23), severity of illness (OR 1.02; 95% CI 1.02–1.03), hypotension (OR 1.13; 95% CI 1.04–1.24), and certain medications (vancomycin and calcineurin inhibitors) were all independently associated with AKI. AKI was a significant predictor for longer length of stay, ICU mortality, and mortality after discharge. Conclusions AKI is a common event for young adults admitted to an adult tertiary care center ICU with an associated increased length of stay and risk of mortality. Potentially modifiable risk factors for AKI including medications were identified for all stratified age groups. |
| first_indexed | 2024-12-13T13:38:52Z |
| format | Article |
| id | doaj.art-b9044b38db8e4e34a49e146ebe2e3dff |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-13T13:38:52Z |
| publishDate | 2018-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-b9044b38db8e4e34a49e146ebe2e3dff2022-12-21T23:43:38ZengSpringerOpenAnnals of Intensive Care2110-58202018-02-018111110.1186/s13613-018-0373-yAcute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unitDana Y. Fuhrman0Sandra Kane-Gill1Stuart L. Goldstein2Priyanka Priyanka3John A. Kellum4Children’s Hospital of PittsburghSchool of Pharmacy, University of PittsburghCenter for Acute Care Nephrology, Cincinnati Children’s Hospital Medical CenterThe Center for Critical Care NephrologyThe Center for Critical Care NephrologyAbstract Background Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16–25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16–55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality. Results AKI developed in 52.6% (n = 8270) of the entire cohort and in 39.8% of the young adult age group (16–25 years). The AUCs for the age categories were similar at 0.754, 0.769, 0.772, and 0.770 for the 16–25-, 26–35-, 36–45-, and 45–55-year age groups, respectively. For the youngest age group, diabetes (OR 1.89; 95% CI 1.09–3.29), surgical reason for admission (OR 1.79; 95% CI 1.44–2.23), severity of illness (OR 1.02; 95% CI 1.02–1.03), hypotension (OR 1.13; 95% CI 1.04–1.24), and certain medications (vancomycin and calcineurin inhibitors) were all independently associated with AKI. AKI was a significant predictor for longer length of stay, ICU mortality, and mortality after discharge. Conclusions AKI is a common event for young adults admitted to an adult tertiary care center ICU with an associated increased length of stay and risk of mortality. Potentially modifiable risk factors for AKI including medications were identified for all stratified age groups.http://link.springer.com/article/10.1186/s13613-018-0373-yYoung adultAcute kidney injury (AKI)Critically ill |
| spellingShingle | Dana Y. Fuhrman Sandra Kane-Gill Stuart L. Goldstein Priyanka Priyanka John A. Kellum Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit Annals of Intensive Care Young adult Acute kidney injury (AKI) Critically ill |
| title | Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit |
| title_full | Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit |
| title_fullStr | Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit |
| title_full_unstemmed | Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit |
| title_short | Acute kidney injury epidemiology, risk factors, and outcomes in critically ill patients 16–25 years of age treated in an adult intensive care unit |
| title_sort | acute kidney injury epidemiology risk factors and outcomes in critically ill patients 16 25 years of age treated in an adult intensive care unit |
| topic | Young adult Acute kidney injury (AKI) Critically ill |
| url | http://link.springer.com/article/10.1186/s13613-018-0373-y |
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