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Injuria renal aguda Aspectos epidemiol gicos PowerPoint Presentation
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Injuria renal aguda Aspectos epidemiol gicos

Injuria renal aguda Aspectos epidemiol gicos

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Injuria renal aguda Aspectos epidemiol gicos

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    1. Injuria renal aguda Aspectos epidemiolgicos Dr. Jordn Tenzi 9/7/07

    2. Liao F, Pascua J and The Madrid Acute Renal Failure Study Group, Kidney Int 1996; 50: 8111-818 Incidencia: 209/milln/ao (748/4.227.837) Etiologa: -NTA 45% -Prerrenal 21% -IRC agudizada 13% -Obstructiva 10% Origen: Extrahospitalario: 49.7% Hospitalario: 50.3% -Medicina: 34% -UCI: 27% -Ciruga: 23% Sexo: predominio masculino Edad: incidencia aumenta con la misma

    3. Liao F, Pascua J and The Madrid Acute Renal Failure Study Group, Kidney Int 1996; 50: 8111-818 Mortalidad: 45% NTA: 60% Prerenal: 35% IRC agudizada: 35% Obstructiva: 27% Nefritis intersiticial aguda: 13% Vasculitis: 45% Glomerulonefritis primaria: 9% Glomerulonefritis secundaria: 25%

    5. The epidemiology of acute renal failure: 1975 versus 2005

    11. AKI incidence of 5% (109 of 2216 medical and surgical patients). AKI was associated with decreased renal perfusion (42%), major surgery (18%), radiocontrast exposure (12%), and aminoglycoside administration (7%). Predictors of poor prognosis included oliguria and the severity of the renal dysfunction.

    14. Compared a cohort of 183 patients with radiocontrast-associated AKI and 174 patients who were matched for age and baseline SCr and underwent similar diagnostic procedures without developing AKI. The mortality rate was 34% in patients with AKI versus 7% in patients without AKI. Adjusting for differences in comorbidity, the odds of death were increased 5.5-fold in the AKI group.

    19. From this population, only patients who were treated with renal replacement therapy (RRT) other than for drug poisoning or who had at least 1 of the predefined criteria for ARF were included in the study. The criteria for ARF were oliguria defined as urine output of less than 200 mL in 12 hours and/or marked azotemia defined as a blood urea nitrogen level higher than 84 mg/dL

    29. Rialp G, Roglan A; Renal Failure 1996; 18: 667-675 Incidencia de IRA en UCI: 21.4% AP: HTA 34.2% inmunodepresin: 27.3% diabetes: 17.5% Mortalidad: con IRA 46.6% p= 0.0001 sin IRA 17.6%

    30. Injuria Renal Aguda en Medicina Intensiva Encuesta Multicntrica Nacional J Tenzi, A Ferreiro, R Lombardi, E Schwedt, N Nin, M Cancela, F Gonzalez y colaboradores 2006

    31. Montevideo: 18 instituciones (25 UCI) Interior: 15 instituciones (15 UCI) Total UCI encuestadas: 40 (83%) % UCI Montevideo encuestadas: 100% % UCI Interior encuestadas: 65% Incidencia de IRA: 9.12% (66/723)

    37. Mortalidad pacientes con IRA: 32/66 (48.5%) -Montevideo 23/53 (43.4%) -Interior 9/13 (69.2%) Mortalidad pacientes sin IRA: 107/657 (16.2%) -Montevideo 88/518 (16.9%) -Interior 19/139 (13.6%)

    39. Sobreviven Fallecen Valor p DOM si 12 (35.3%) 22 (64.7%) < 0.05 DOM No 21 (67.7%) 10 (32.3%)