■科威特的急性肾损伤(AKI)发病率和转归未知。此外,非科威特人,占总人口的66%,收入较低,与可以免费获得全面服务的科威特人相比,他们获得公共卫生服务的机会受到限制。
■观察性前瞻性多中心队列研究。
■2021年1月1日至12月31日,7家公立医院的AKI成年住院患者。
■使用肾脏病识别AKI:改善基于血清肌酐的全球结局标准。
■对于AKI的住院患者,结果包括30天的死亡率,需要透析,肾脏恢复率,以及科威特人和非科威特人的结局差异。
■进行反向逐步多元逻辑回归分析,以评估结果可能的独立危险因素。
■我们招募了3,744名患者(平均年龄:63岁;平均基线估计肾小球滤过率[eGFR]:66.7mL/min;非科威特人:42.3%),占住院治疗的3.2%和重症监护病房(ICU)入院的19.5%。非科威特人明显年轻(57.6岁vs66.9岁),具有较高的基线eGFR(73.1vs.62mL/min),更频繁的社区获得性AKI(53.8%对46.7%),夏季AKI(34.7%对26.9%)。为33.5%的患者提供透析,对非科威特人的需求较高(35.5%vs32.1%)。在30天,34.4%的患者死亡,占医院死亡率的24.8%和ICU死亡率的59.8%。科威特人和非科威特人之间的死亡率或肾脏恢复没有差异。低eGFR不影响死亡率。
■仅30天的观察性和短随访期。
■AKI与高透析需求和死亡率相关。尽管占总人口的66%,但非科威特人的病例较少,因为他们较年轻,基线eGFR较高,合并症较少。非科威特人在夏季社区获得性AKI和AKI的发生率较高,透析需求较高,但死亡率和肾脏完全恢复率相似。
急性肾损伤(AKI)的发病率,其管理,其结果在科威特未知。此外,科威特有大量不同种族的外籍人士,他们的收入较低,享受不到同样水平的公立医院服务。我们在科威特的几家公立医院招募了诊断为AKI的住院成年人。我们分析了特点,管理,以及3,700多名患者的结局数据,发现AKI影响了3.2%的住院患者。AKI导致高透析利用率并导致高死亡率。尽管更多的科威特人受到AKI的影响,科威特人和非科威特人的死亡率相似.与科威特人相比,非科威特人更年轻,基线肾功能更好,慢性疾病更少。
UNASSIGNED: Acute kidney injury (AKI) incidence and outcome in
Kuwait are unknown. Moreover, non-Kuwaitis, who represent 66% of the population, have lower income, and their access to public health services is restricted compared with Kuwaitis who have free full access.
UNASSIGNED: Observational prospective multicenter cohort study.
UNASSIGNED: Adult inpatients with AKI in 7 public hospitals from January 1 to December 31, 2021.
UNASSIGNED: AKI identified using Kidney Disease: Improving Global Outcomes serum creatinine-based criteria.
UNASSIGNED: For hospitalized patients with AKI, the outcomes included 30-day outcomes of mortality, need for dialysis, kidney recovery rates, and differences in outcomes between Kuwaitis and non-Kuwaitis.
UNASSIGNED: A backward stepwise multiple logistic regression analysis was performed to assess possible independent risk factors for the outcomes.
UNASSIGNED: We recruited 3,744 patients (mean age: 63 years; mean baseline estimated glomerular filtration rate [eGFR]: 66.7 mL/min; non-Kuwaitis: 42.3%), representing 3.2% of hospitalizations and 19.5% of intensive care unit (ICU) admissions. Non-Kuwaitis were significantly younger (57.6 vs 66.9 years), with higher baseline eGFR (73.1 vs. 62 mL/min), more frequent community acquired AKI (53.8% vs 46.7%), and AKI in summer (34.7% vs 26.9%). Dialysis was provided to 33.5% of patients, with a higher need for non-Kuwaitis (35.5% vs 32.1%). At 30 days, 34.4% of patients died, representing 24.8% of hospital mortality and 59.8% of ICU mortality. No differences in mortality or kidney recovery were noted between Kuwaitis and non-Kuwaitis. Low eGFR did not affect the mortality rate.
UNASSIGNED: Observational nature and short follow-up period of 30 days only.
UNASSIGNED: AKI was associated with high dialysis need and mortality. Non-Kuwaitis accounted for less cases despite representing 66% of the population because they were younger with higher baseline eGFR and fewer comorbid conditions. Non-Kuwaitis had higher rates of community acquired AKI and AKI in summer and a higher need for dialysis but had similar mortality and complete kidney recovery rates.
Incidences of acute kidney injury (AKI), its management, and its outcomes are unknown in
Kuwait. In addition,
Kuwait has a large population of ethnically diverse expatriates who have lower income and do not enjoy the same level of access to public hospital services. We recruited hospitalized adults who have a diagnosis of AKI in several public hospitals in
Kuwait. We analyzed characteristics, management, and outcomes data for more than 3,700 patients and found that AKI affects 3.2% of hospitalized patients. AKI leads to high dialysis utilization rates and causes high mortality rates. Although more Kuwaitis were affected by AKI, the mortality rates for Kuwaitis and non-Kuwaitis were similar. Non-Kuwaitis were younger with better baseline kidney function and fewer chronic diseases than Kuwaitis.