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Background <p>Acute kidney injury (AKI) is associated with significant morbidity and mortality in critically ill patients. However, data on AKI in coronary care units (CCU) remain limited, particularly in low- and middle-income countries. This study aimed to determine the incidence, etiology, risk factors, and outcomes of AKI in a CCU setting in Thailand.</p> Methods <p>In this retrospective cohort study, we analyzed 209 patients admitted to a tertiary hospital CCU between January 2019 and September 2020. We collected data on baseline characteristics, comorbidities, medications, clinical parameters, and outcomes. Risk factors were assessed using multivariable logistic regression analysis.</p> Results <p>AKI occurred in 30.6% of patients, with multifactorial etiologies being the most common (42.2%). AKI was associated with significantly higher mortality at both 30 days (35.9% vs. 3.4%, <i>p</i> &lt; 0.001) and 90 days (43.8% vs. 6.9%, <i>p</i> &lt; 0.001). Independent risk factors for AKI included pre-existing chronic kidney disease (adjusted OR 3.47), reduced left ventricular ejection fraction (OR 3.19), mechanical ventilation (OR 3.08), and vasopressor use (OR 2.84). Independent predictors of kidney replacement therapy were mechanical ventilation (OR 11.26) and vasopressor use (OR 5.61).</p> Conclusions <p>AKI is a frequent and severe complication among CCU patients in a low- to middle-income country, significantly increasing short-term mortality and hospital stay. Early identification of high-risk patients may improve outcomes through timely intervention and monitoring.</p>

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Acute kidney injury in a cardiac ICU in a middle-income country: risk factors and outcomes from Thailand

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月7日

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  • Supassara Nimkulrat,
  • Nitcha Suphatheerawatr,
  • Punnawit Laungchuaychok,
  • Ukrit Prajantasen,
  • Sathit Kurathong,
  • Wanjak Pongsittisak,
  • Solos Jaturapisanukul

摘要

Background

Acute kidney injury (AKI) is associated with significant morbidity and mortality in critically ill patients. However, data on AKI in coronary care units (CCU) remain limited, particularly in low- and middle-income countries. This study aimed to determine the incidence, etiology, risk factors, and outcomes of AKI in a CCU setting in Thailand.

Methods

In this retrospective cohort study, we analyzed 209 patients admitted to a tertiary hospital CCU between January 2019 and September 2020. We collected data on baseline characteristics, comorbidities, medications, clinical parameters, and outcomes. Risk factors were assessed using multivariable logistic regression analysis.

Results

AKI occurred in 30.6% of patients, with multifactorial etiologies being the most common (42.2%). AKI was associated with significantly higher mortality at both 30 days (35.9% vs. 3.4%, p < 0.001) and 90 days (43.8% vs. 6.9%, p < 0.001). Independent risk factors for AKI included pre-existing chronic kidney disease (adjusted OR 3.47), reduced left ventricular ejection fraction (OR 3.19), mechanical ventilation (OR 3.08), and vasopressor use (OR 2.84). Independent predictors of kidney replacement therapy were mechanical ventilation (OR 11.26) and vasopressor use (OR 5.61).

Conclusions

AKI is a frequent and severe complication among CCU patients in a low- to middle-income country, significantly increasing short-term mortality and hospital stay. Early identification of high-risk patients may improve outcomes through timely intervention and monitoring.