Clinical analysis of acute kidney injury with the brain diseases in ICU

Objective To explore the risk factors for acute kidney injury in ICU during the course of treatment of brain diseases and its prognostic factors. Methods The medical records of hospitalized patients in ICU from June,2011 to July,2015 were collected,all AKI with the brain diseases were selected,a total of 59 cases.According to the conditions of the brain disease patients with AKI,we collected the general data (including age, gender,Glasgow Coma Scale, with or without chronic diseases.), the special data (including indexes of renal function, whether there is shock,surgery,whether there is the use of nephrotoxic drugs, the total amount of mannitol), as well as the prognosis,ICU stay and costs.Through the AKIN diagnostic criteria is graded, the relationship between the prognosis of the patients and the prognosis of the patients at 28 days and discharged are observed, the relationship between AKI and prognosis of patients are analyzed by single factor variance analysis,and the risk factors for disease stage and prognosis are analyzed by Logistic regression analysis. Results AKI Ⅰ,Ⅱ and Ⅲ were accounted for 39.0%,30.5% and 30.5%,respectively,the proportion of cured or improved is 45.8%,and the proportion of non-healing patients accounted for 54.2%.GCS score of 5(4,7) of all patients,1 000(400,1 440) of the total use of mannitol,22 patients with renal toxicity drugs,ICU length of stay is 14(13,23)d,a total cost of 5.7(4.5,8.6) million.Risk factors for AKI staging:GCS score,whether there is the use of nephrotoxic drugs and whether having chronic diseases,factors affecting the outcome such as Age,GCS score,whether there is the use of nephrotoxic drugs,sex and AKI classification,and the higher the AKI staging,the higher hospitalization time and costs. Conclusion There is a high mortality rate in patients of acute kidney injury with the brain diseases in ICU.The clinicians require attaching great importance to its various risk factors, to make early prevention and early diagnosis of brain disease with AKI,which can improve the prognosis and reduce the economic burden of patients.