Name: Alan Diniz Ferreira
Type: MSc dissertation
Publication date: 25/04/2018
Advisor:

Namesort descending Role
Jose Geraldo Mill Advisor *

Examining board:

Namesort descending Role
Jose Geraldo Mill Advisor *

Summary: The development of acute kidney injury (AKI) is an indicator of bad prognosis in hospitalized patients and an important factor for progression to chronic kidney disease (CKD). CKD is as important factors that contributes contributor to mortality and costs wit health care. Therefore, it is important to determine the factors present in patients with AKI and that contribute to mortality and progression to CKD. Objective: Evaluate predictors of mortality in patients with AKI with evolution to RRT (Renal Replacement Therapy) during hospitalization and follow up of survivors 6 months after discharge. Methods: Descriptive, observational and prospective study, in a series of consecutive cases involving hemodialysis during hospitalization. Results: Inclusion of 80 cases, being septic AKI (32 cases) and multifactorial (29 cases) the most frequent causes of AKI. There was a high frequency of risk factors for CKD. The correlation between the severity of the patient with predicted mortality by SAPSII (Simplified Acute Physiology Score) is not satisfactory, underestimating the overall mortality of cases in RRT-AKI, which was 60% (48) with higher mortality in patients who waited more time for the nephrologist's evaluation. Of the survivors (32), 11 (61%) followed in TSR. The analysis of survival during hospitalization showed that from the onset of RRT, there is no difference in risk of death between cases with baseline creatinine up to 1.5mg / dL or greater than 1.5mg / dL (Long-rank = 1.084, p = 0.29 HR = 0.47, p = 0.10). In the follow-up analysis, there was no difference in the risk of death between patients with RRT and no RRT (HR = 0.320, p = 0.169). The occurrence of 8 deaths (25%) was recorded during follow-up after discharge. Conclusion: The mortality in AKI incident on hemodialysis is high. The creatinine value at admission was the main marker of mortality. LRA is a serious complication, especially in inpatients and should not be neglected.

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