Early nephrology consultation can have an impact on outcome of acute kidney injury patients

Página do item simplificado
dc.contributor.authorPonce, Daniela [UNESP]
dc.contributor.authorFranco Zorzenon, Caroline de Pietro [UNESP]
dc.contributor.authordos Santos, Nara Yamane [UNESP]
dc.contributor.authorBalbi, André Luis [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-20T13:33:27Z
dc.date.available2014-05-20T13:33:27Z
dc.date.issued2011-10-01
dc.description.abstractBackground. Patients who develop acute kidney injury (AKI) in the intensive care unit (ICU) have extremely high rates of mortality and morbidity. The objectives of this study were to compare clinical and laboratory characteristics of AKI patients evaluated and not evaluated by nephrologists in ICU and generate the hypothesis of the relationship between timing of nephrology consultation and outcome.Methods. We explored associations among presence and timing of nephrology consultation with ICU stay and in-ICU mortality in 148 ICU patients with AKI at a Brazilian teaching hospital from July 2008 to May 2010. Multivariable logistic regression was used to adjust confounding and selection bias.Results. AKI incidence was 30% and 52% of these AKI patients were evaluated by nephrologists. At multivariable analysis, AKI patients evaluated by nephrologists showed higher Acute Tubular Necrosis-Index Specific Score and creatinine level, more dialysis indications, lower urine output and longer ICU stay. The mortality rate was similar to AKI patients who were not evaluated. Nephrology consultation was delayed (>= 48 h) in 62.3% (median time to consultation, 4.7 days). Lower serum creatinine levels (P - 0.009) and higher urine output (P = 0.002) were associated with delayed consultation. Delayed consultation was associated with increased ICU mortality (65.4 versus 88.2%, P < 0.001).Conclusions. In AKI, patients evaluated by nephrologists seem to be more seriously ill than those not evaluated and present similar mortality rate. The delayed nephrology consultation can be associated with increased ICU mortality.en
dc.description.affiliationUNESP, Dept Internal Med, Botucatu Sch Med, Botucatu, SP, Brazil
dc.description.affiliationUnespUNESP, Dept Internal Med, Botucatu Sch Med, Botucatu, SP, Brazil
dc.format.extent3202-3206
dc.identifierhttp://dx.doi.org/10.1093/ndt/gfr359
dc.identifier.citationNephrology Dialysis Transplantation. Oxford: Oxford Univ Press, v. 26, n. 10, p. 3202-3206, 2011.
dc.identifier.doi10.1093/ndt/gfr359
dc.identifier.issn0931-0509
dc.identifier.lattes5697804493071661
dc.identifier.urihttp://hdl.handle.net/11449/11463
dc.identifier.wosWOS:000296349200024
dc.language.isoeng
dc.publisherOxford University Press
dc.relation.ispartofNephrology Dialysis Transplantation
dc.relation.ispartofjcr4.600
dc.relation.ispartofsjr2,142
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.subjectacute kidney injuryen
dc.subjectintensive care uniten
dc.subjectmortalityen
dc.subjectnephrology consultationen
dc.titleEarly nephrology consultation can have an impact on outcome of acute kidney injury patientsen
dc.typeArtigo
dcterms.licensehttp://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
dcterms.rightsHolderOxford Univ Press
unesp.author.lattes5697804493071661[4]
unesp.author.orcid0000-0001-8366-5064[4]
unesp.author.orcid0000-0002-6178-6938[1]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

Arquivos

Licença do Pacote
Agora exibindo 1 - 2 de 2
Nenhuma Miniatura disponível
Nome:
license.txt
Tamanho:
1.71 KB
Formato:
Item-specific license agreed upon to submission
Descrição:
Nenhuma Miniatura disponível
Nome:
license.txt
Tamanho:
1.71 KB
Formato:
Item-specific license agreed upon to submission
Descrição:

Coleções

Artigos - Clínica Médica - FMB