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125 ACUTE KIDNEY INJURY IN LEPTOSPIROSIS STUDY
1ST ASIA PACIFIC AKI CRRT 2017 Keywords: Early and late Nephrology referral; AKI; outcome; Introduction: Acute kidney injury (AKI) is common in hospital setting.
It is a known risk factor for prolonged stay and increased mortality during hospitalization. Nephrology consult and timely intervention is vital in the management of these patients. Objective: This study is to determine the incidence of AKI, timing of Nephrology referral and its impact on the outcome of AKI patients. Method: This single center, cross sectional study included patients admitted to Kuala Lumpur Hospital in March 2017 and diagnosed to have AKI based on KDIGO criteria. Data are captured from computerized database and patients’ clinical notes. Analysis was done retrospectively to describe the incidence and the outcome (upon discharge) of early (within 2 days from the diagnosis of AKI) and late Nephrology referral (> 2 days from the diagnosis of AKI). Result: In the one-month period, total 7727 adult admissions were recorded in which 161 patients were excluded because of untraceable records. 385 AKI patients were identified and 80 of them were referred to Nephrology service. Patients with Nephrology referral had mean SD age of 55.4 14.2 years with 61.2% male predominance. 62 (77.5%) were early referral. There were no significant demographic and AKI etiology difference between these two groups of patients. In this study, AKI patients with Nephrology consult had significant longer hospital stay (p<0.001) and higher mortality (p<0.001). AKI associated with infection and renal replacement therapy (RRT) requirement were associated with high mortality, despite early Nephrology consult. There was no association between initiation of RRT and timing of Nephrology consult (p-0.103). RRT was initiated in 23(37.1%) and 11(61.1%) patients in the early and late referral group respectively. Overall, early Nephrology referral showed a trend towards improved survival but not statistically significant (p-0.090). However, early Nephrology referral had higher rate of full renal recovery and lower mortality (p-0.019) in the subgroup analysis of comparing these two groups alone. In addition to that, early referral had absolute risk reduction of 22.6% and relative risk reduction of 45.2% with respect to mortality. Conclusion: Incidence of AKI in this study was 7%. AKI patients who required Nephrology consult were most likely in critical condition and thus had poorer outcome. In this study, early Nephrology consult did not show significant mortality reduction possibly due to small sample size and limited study period.
121 IN-HOSPITAL ACUTE KIDNEY INJURY BY ELECTRONIC ALERT AND MORTALITY PREDICTION LOW, Sanmay1,2, MURALI, Tanusya M1,2, VATHSALA, A1,2, Nicole, NG2, CHUA, Horng-Ruey1,2 1 Division of Nephrology, University Medicine Cluster, National University Hospital, AND, 2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
Category: Epidemiology and Outcomes from AKI Presenter: Dr HORNG-RUEY CHUA Keywords: acute kidney injury epidemiology, electronic healthcare
records and alert, mortality, critical care nephrology, pneumonia, solid organ malignancy, hospitalisation outcomes, electronic data mining Background and Hypothesis: Development and progression of acute kidney injury (AKI) reflect the global severity of acute illnesses in hospitalized patients. The latter and AKI severity may predict adverse outcomes. Methods: We identified inpatients aged >18 years diagnosed with AKI over one year in a tertiary institution, detected by electronic AKI alert since Nov’15, based on modified KDIGO criterion. We examined AKI severity and predictors of hospital mortality and composite outcome (progression to stage 3 AKI, renal replacement therapy (RRT), and mortality). Results: We reported 3355 unique patient-events, including 421 patients from initial ICU setting. 2330 were medical patients (versus surgical). 1295 had hospital-associated AKI (versus community-acquired). Peak KDIGO-AKI stages were one (61%), two (20%), three (19%) respectively. 393 patients (12%) suffered in-hospital mortality, and 619 (18%) met the composite outcome (including 196 receiving RRT). Mortality rate was incremental from peak KDIGO-AKI stages one (6%), two (15%), to three (27%) (p<0.001). Patients who died (versus survivors) were older (age 7015 versus 6516 years), and less had diabetes mellitus (30% versus 37%), while more had liver cirrhosis and cerebrovascular disease respectively (p<0.05). Correspondingly, Kidney International Reports (2017) 2, S1–S41
between fatalities versus survivors, 57% versus 36% had critical illness, 82% versus 68% were medical patients, 44% versus 38% had hospital-associated AKI, 22% versus 8% had pneumonia, 22% versus 17% had acute cardiac diseases, 27% versus 14% had solid organ malignancies, and more fatalities had decompensated liver disease and acute ischemic stroke (all p<0.05). On multivariate analyses, older age, critical illness, medical specialties, pneumonia, solid organ malignancies, acute cardiac diseases, decompensated liver disease, were adversely associated with both mortality and composite outcome. Additionally, hematological malignancies, trauma, acute stroke, baseline CKD predicted the composite outcome. Conclusions: Case fatality is high with significant renal deterioration among inpatients with AKI not confined to critical care, and significantly influenced by nature of underlying diseases.
124 HISTOPATHOLOGY FINDINGS OF RENAL BIOPSIES PERFORMED IN PATIENTS WITH ACUTE KIDNEY INJURY Esther, TZZ1, Anuar, S1, Wong, HS1,2, Goh, CY1 1
Department of Nephrology, Selayang Hospital, 2Clinical Research Centre, Selayang Hospital
Category: Epidemiology and Outcomes from AKI Presenter: Dr Shahnon Anuar Keywords: Acute kidney injury, renal biopsy findings Introduction: Renal biopsy in acute kidney injury (AKI) provides
important information for diagnosis, treatment, and prognosis. Objective:
1. To ascertain the renal pathologic correlations of native renal biopsies done for AKI in Selayang Hospital. 2. To ascertain the renal and patient outcome of the AKI at 3 months’ post renal biopsy. Methodology: This retrospective study was performed on all patients who underwent renal biopsies for AKI in Selayang Hospital from 1.1.2015 to 31.12.2016. Patients’ demography, clinical and histopathology data, laboratory results, renal and patient outcome were retrieved from hospital’s electronic medical record. Results were analyzed using SPSS version 23. Results: Between the years 2015-2016, 230 native renal biopsies were done. Of these, 22% (51 patients) had AKI. Mean age were 34.6 15.5 years. Twenty-eight (54.9%) were male and 21 (41.2%) had no prior medical illness. Forty-nine biopsies (96.1%) were done at the inferior pole of the left kidney. The renal histopathology results of the biopsies were: Lupus nephritis, 39.2% (20), Focal segmental glomerulosclerosis (FSGS), 13.7% (7), IgA nephropathy, 7.8% (4), Membranoproliferative glomerulonephritis, 3.9% (2), Membranous nephropathy, 3.9% (2), Minimal change disease, 9.8% (5), Postinfectious glomerulonephritis, 2% (1), Acute Interstitial Nephritis, 5.9% (3), Anti-neutrophil Cytoplasm Antibodies-associated glomerulonephritis, 2% (1). Four patients (7.8%) had inconclusive renal biopsies. Two (3.9%) had chronic tubulointerstitial damage on the renal biopsy. Twenty-six patients (51%) had full recovery of renal function while 13 (25.5%) developed chronic kidney disease. Two (3.9%) require longterm renal replacement therapy; one had crescentic IgA nephropathy, the other had nonHodgkin’s lymphoma with membranoproliferative glomerulonephritis with severe chronic tubulointerstitial changes. Two patients died less than 3 months post renal biopsy due to complications related to underlying disease (both patients had lupus nephritis class IV on renal biopsy). Conclusions: The prevalence of lupus nephritis is high in the younger age group (12-30 years old). These data highlight the value of renal biopsy in guiding management strategies in patients with AKI.
125 ACUTE KIDNEY INJURY IN LEPTOSPIROSIS STUDY Esther, TZZ1, Wong, HS1,2, Anuar, S1, Yakob, S1, Goh, CY1 1
Department of Nephrology, Selayang Hospital, Selangor, Malaysia, 2Clinical Research Centre, Selayang Hospital, Selangor, Malaysia
S17
1ST ASIA PACIFIC AKI CRRT 2017 Category: Epidemiology and Outcomes from AKI Presenter: Dr ESTHER ZHAO ZHI TAN Keywords: Acute kidney injury, leptospirosis Introduction: Leptospirosis, a zoonosis cause by Leptospira, is
endemic in the tropics and is a relatively important cause of acute kidney injury (AKI) in this region. Mortality has been reported to be as high as 15-18% in those with AKI in the 1990’s but there is lack of data on renal and patient outcome in this current age with the improvement of diagnostic techniques [microscopic agglutination test (MAT) is currently the gold standard], renal support and medical care. Objective: To study the incidence and outcome of acute kidney injury in patients with leptospirosis Methodology: This retrospective study was performed on all patients admitted from 1st January 2015 to 31stDecember 2016. Patients with confirmed leptospirosis (ie positive for both IgM antibodies and MAT) were identified from the Hospital Laboratory Information System (LIS). Patients’ demography, relevant clinical data, laboratory results, renal outcome and patient outcome were retrieved from hospital’s electronic medical record. Subjects with incomplete data were excluded. Results were analysed using SPSS version 23. Results: Of a total of 125,243 admissions, 35 patients were admitted with confirmed leptospirosis. Twenty-three patients (65.7%) developed AKI. The mean age of those with AKI was 35.7 19.2 years and 21 (92.3%) were male. Thirteen (56.5%) were Malay while Chinese, Indians and others accounted 5 (21.7%), 4 (17.4%) and 1 (4.3%) respectively. Only 14 (60.9%) received renal consults and 4 (17.4%) required dialysis support. One patient who required dialysis, died during the admission giving a mortality rate of 4.3%. At time of discharge, 18 (78.3%) had complete renal recovery, 4 (17.4%) developed chronic kidney disease and 1 (4.3%) died before discharge. None of the patients required dialysis support at discharge. Compared to the 12 patients who did not develop AKI, male gender was found to be a risk factor of developing AKI (p¼0.023). There was a suggestion that older patients have a higher preponderance of developing AKI but this did not reach statistical significance. Conclusion: AKI is common in leptospirosis with an incidence of 65.7% but with a favorable outcome where 78.3% have a complete AKI recovery. Male gender appeared to be a risk factor of developing leptospirosis associated AKI.
tertiary cardiothoracic centre in Malysia. The primary outcome was defined as the need for renal replacement therapy after cardiac surgery. The performance of the Cleveland Score was measured by means of their discrimination and calibration. Results: All patient were scored and grouped into 4 risk groups based on the Cleveland model. Overall incidence of AKI-D was 10.3% in our Serdang cohort. The incidence of AKI-D ranged between 4.7% and 80% across the 4 risk categories. When compared to the Cleveland cohort, the incidence of AKI-D in all risk categories were remarkably higher than the 95% confidence interval (CI) of the corresponding AKI-D incidence in the Cleveland Cohort. Discrimination of the model is good, with area under the receiving operator characteristics curve (AU-ROC) of 0.811. Calibration is also good with the p-value of Hosmer and Lameshow test (H-L) >0.05. Conclusion: The Cleveland Score is useful in discriminating between patients with a higher or lower risk of developing AKI-D in our population.
126 VALIDATING CLEVELAND CLINIC SCORE TO PREDICT ACUTE KIDNEY INJURY REQUIRING DIALYSIS AFTER CARDIAC SURGERY Goh, KW1, Goh, BL1, Ibrahim, FH1, Lim, CTS2, Fadhlina, NZ2, Nor, M Arif M3, Loh, WC4, Kasmin, FA1, Lam, KR1, Evi Diana, O5 1 Nephrology Department, Serdang Hospital, 43300 Kajang, Selangor, Malaysia, 2Nephrology Unit, Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia, 43400 UPM, Selangor, Malaysia, 3Cardio thoracic Surgery Department, Serdang Hospital, 43300 Kajang, Selangor, Malaysia, 4 Internal Medicine Department, Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia, 43400 UPM, Selangor, Malaysia, 5Clinical Research Centre, Serdang Hospital, 43300 Kajang, Selangor, Malaysia
Category: Epidemiology and Outcomes from AKI Presenter: Dr KHENG WEE GOH Keywords: Cardiac Surgery, Acute kidney Injury, Risk prediction Introduction: Acute kidney injury requiring dialysis (AKI-D) is one of
the most feared complication following cardiac surgery, which results in significant mortality and prolonged hospital stay. Patients, especially those with chronic kidney disease (CKD), are often referred to physicians for pre-operative renal assessment and management. A useful and accurate risk score can identify patients at risk for acute kidney injury (AKI) and facilitate preventive strategies preoperative and perioperatively. Several risk scores have been developed for this purpose, but few have been validated in Asian population. Objective: We aim to externally validate the Cleveland Score in our Asian population. The Cleveland Score was chosen as it was developed from a large cohort, has very good discrimination, and has been externally validated in many centres. It also has the advantage of only using preoperative variables, thus allowing risk stratification of patients before the operation. Methodology: A retrospective analysis was conducted on 1741 patients who underwent cardiac surgery during a 5-year period (2011-2015) at a S18
128 CLINICAL VARIABLES IN POOR OUTCOME PATIENT WITH ACUTE KIDNEY INJURY RECEIVING CONTINUOUS VENO VENOUS HEMOFILTRATION THERAPY Hazlina, WM, Asiah, U, Norazinizah, AM, Suhaidarwani, AH, Abdul Wahab, MZ, Visvanathan, R Department of Nephrology, Hospital Kuala Lumpur (HKL), Federal Territory of Kuala Lumpur, Malaysia
Category: Epidemiology and Outcomes from AKI Presenter: Dr WAN HAZLINA WAN MOHAMAD Keywords: Clinical variables, poor outcome, AKI, CVVH Introduction: Acute kidney injury (AKI) is a common complication of
critically ill patients. Patients who received continuous veno venous Kidney International Reports (2017) 2, S1–S41
It is a known risk factor for prolonged stay and increased mortality during hospitalization. Nephrology consult and timely intervention is vital in the management of these patients. Objective: This study is to determine the incidence of AKI, timing of Nephrology referral and its impact on the outcome of AKI patients. Method: This single center, cross sectional study included patients admitted to Kuala Lumpur Hospital in March 2017 and diagnosed to have AKI based on KDIGO criteria. Data are captured from computerized database and patients’ clinical notes. Analysis was done retrospectively to describe the incidence and the outcome (upon discharge) of early (within 2 days from the diagnosis of AKI) and late Nephrology referral (> 2 days from the diagnosis of AKI). Result: In the one-month period, total 7727 adult admissions were recorded in which 161 patients were excluded because of untraceable records. 385 AKI patients were identified and 80 of them were referred to Nephrology service. Patients with Nephrology referral had mean SD age of 55.4 14.2 years with 61.2% male predominance. 62 (77.5%) were early referral. There were no significant demographic and AKI etiology difference between these two groups of patients. In this study, AKI patients with Nephrology consult had significant longer hospital stay (p<0.001) and higher mortality (p<0.001). AKI associated with infection and renal replacement therapy (RRT) requirement were associated with high mortality, despite early Nephrology consult. There was no association between initiation of RRT and timing of Nephrology consult (p-0.103). RRT was initiated in 23(37.1%) and 11(61.1%) patients in the early and late referral group respectively. Overall, early Nephrology referral showed a trend towards improved survival but not statistically significant (p-0.090). However, early Nephrology referral had higher rate of full renal recovery and lower mortality (p-0.019) in the subgroup analysis of comparing these two groups alone. In addition to that, early referral had absolute risk reduction of 22.6% and relative risk reduction of 45.2% with respect to mortality. Conclusion: Incidence of AKI in this study was 7%. AKI patients who required Nephrology consult were most likely in critical condition and thus had poorer outcome. In this study, early Nephrology consult did not show significant mortality reduction possibly due to small sample size and limited study period.
121 IN-HOSPITAL ACUTE KIDNEY INJURY BY ELECTRONIC ALERT AND MORTALITY PREDICTION LOW, Sanmay1,2, MURALI, Tanusya M1,2, VATHSALA, A1,2, Nicole, NG2, CHUA, Horng-Ruey1,2 1 Division of Nephrology, University Medicine Cluster, National University Hospital, AND, 2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
Category: Epidemiology and Outcomes from AKI Presenter: Dr HORNG-RUEY CHUA Keywords: acute kidney injury epidemiology, electronic healthcare
records and alert, mortality, critical care nephrology, pneumonia, solid organ malignancy, hospitalisation outcomes, electronic data mining Background and Hypothesis: Development and progression of acute kidney injury (AKI) reflect the global severity of acute illnesses in hospitalized patients. The latter and AKI severity may predict adverse outcomes. Methods: We identified inpatients aged >18 years diagnosed with AKI over one year in a tertiary institution, detected by electronic AKI alert since Nov’15, based on modified KDIGO criterion. We examined AKI severity and predictors of hospital mortality and composite outcome (progression to stage 3 AKI, renal replacement therapy (RRT), and mortality). Results: We reported 3355 unique patient-events, including 421 patients from initial ICU setting. 2330 were medical patients (versus surgical). 1295 had hospital-associated AKI (versus community-acquired). Peak KDIGO-AKI stages were one (61%), two (20%), three (19%) respectively. 393 patients (12%) suffered in-hospital mortality, and 619 (18%) met the composite outcome (including 196 receiving RRT). Mortality rate was incremental from peak KDIGO-AKI stages one (6%), two (15%), to three (27%) (p<0.001). Patients who died (versus survivors) were older (age 7015 versus 6516 years), and less had diabetes mellitus (30% versus 37%), while more had liver cirrhosis and cerebrovascular disease respectively (p<0.05). Correspondingly, Kidney International Reports (2017) 2, S1–S41
between fatalities versus survivors, 57% versus 36% had critical illness, 82% versus 68% were medical patients, 44% versus 38% had hospital-associated AKI, 22% versus 8% had pneumonia, 22% versus 17% had acute cardiac diseases, 27% versus 14% had solid organ malignancies, and more fatalities had decompensated liver disease and acute ischemic stroke (all p<0.05). On multivariate analyses, older age, critical illness, medical specialties, pneumonia, solid organ malignancies, acute cardiac diseases, decompensated liver disease, were adversely associated with both mortality and composite outcome. Additionally, hematological malignancies, trauma, acute stroke, baseline CKD predicted the composite outcome. Conclusions: Case fatality is high with significant renal deterioration among inpatients with AKI not confined to critical care, and significantly influenced by nature of underlying diseases.
124 HISTOPATHOLOGY FINDINGS OF RENAL BIOPSIES PERFORMED IN PATIENTS WITH ACUTE KIDNEY INJURY Esther, TZZ1, Anuar, S1, Wong, HS1,2, Goh, CY1 1
Department of Nephrology, Selayang Hospital, 2Clinical Research Centre, Selayang Hospital
Category: Epidemiology and Outcomes from AKI Presenter: Dr Shahnon Anuar Keywords: Acute kidney injury, renal biopsy findings Introduction: Renal biopsy in acute kidney injury (AKI) provides
important information for diagnosis, treatment, and prognosis. Objective:
1. To ascertain the renal pathologic correlations of native renal biopsies done for AKI in Selayang Hospital. 2. To ascertain the renal and patient outcome of the AKI at 3 months’ post renal biopsy. Methodology: This retrospective study was performed on all patients who underwent renal biopsies for AKI in Selayang Hospital from 1.1.2015 to 31.12.2016. Patients’ demography, clinical and histopathology data, laboratory results, renal and patient outcome were retrieved from hospital’s electronic medical record. Results were analyzed using SPSS version 23. Results: Between the years 2015-2016, 230 native renal biopsies were done. Of these, 22% (51 patients) had AKI. Mean age were 34.6 15.5 years. Twenty-eight (54.9%) were male and 21 (41.2%) had no prior medical illness. Forty-nine biopsies (96.1%) were done at the inferior pole of the left kidney. The renal histopathology results of the biopsies were: Lupus nephritis, 39.2% (20), Focal segmental glomerulosclerosis (FSGS), 13.7% (7), IgA nephropathy, 7.8% (4), Membranoproliferative glomerulonephritis, 3.9% (2), Membranous nephropathy, 3.9% (2), Minimal change disease, 9.8% (5), Postinfectious glomerulonephritis, 2% (1), Acute Interstitial Nephritis, 5.9% (3), Anti-neutrophil Cytoplasm Antibodies-associated glomerulonephritis, 2% (1). Four patients (7.8%) had inconclusive renal biopsies. Two (3.9%) had chronic tubulointerstitial damage on the renal biopsy. Twenty-six patients (51%) had full recovery of renal function while 13 (25.5%) developed chronic kidney disease. Two (3.9%) require longterm renal replacement therapy; one had crescentic IgA nephropathy, the other had nonHodgkin’s lymphoma with membranoproliferative glomerulonephritis with severe chronic tubulointerstitial changes. Two patients died less than 3 months post renal biopsy due to complications related to underlying disease (both patients had lupus nephritis class IV on renal biopsy). Conclusions: The prevalence of lupus nephritis is high in the younger age group (12-30 years old). These data highlight the value of renal biopsy in guiding management strategies in patients with AKI.
125 ACUTE KIDNEY INJURY IN LEPTOSPIROSIS STUDY Esther, TZZ1, Wong, HS1,2, Anuar, S1, Yakob, S1, Goh, CY1 1
Department of Nephrology, Selayang Hospital, Selangor, Malaysia, 2Clinical Research Centre, Selayang Hospital, Selangor, Malaysia
S17
1ST ASIA PACIFIC AKI CRRT 2017 Category: Epidemiology and Outcomes from AKI Presenter: Dr ESTHER ZHAO ZHI TAN Keywords: Acute kidney injury, leptospirosis Introduction: Leptospirosis, a zoonosis cause by Leptospira, is
endemic in the tropics and is a relatively important cause of acute kidney injury (AKI) in this region. Mortality has been reported to be as high as 15-18% in those with AKI in the 1990’s but there is lack of data on renal and patient outcome in this current age with the improvement of diagnostic techniques [microscopic agglutination test (MAT) is currently the gold standard], renal support and medical care. Objective: To study the incidence and outcome of acute kidney injury in patients with leptospirosis Methodology: This retrospective study was performed on all patients admitted from 1st January 2015 to 31stDecember 2016. Patients with confirmed leptospirosis (ie positive for both IgM antibodies and MAT) were identified from the Hospital Laboratory Information System (LIS). Patients’ demography, relevant clinical data, laboratory results, renal outcome and patient outcome were retrieved from hospital’s electronic medical record. Subjects with incomplete data were excluded. Results were analysed using SPSS version 23. Results: Of a total of 125,243 admissions, 35 patients were admitted with confirmed leptospirosis. Twenty-three patients (65.7%) developed AKI. The mean age of those with AKI was 35.7 19.2 years and 21 (92.3%) were male. Thirteen (56.5%) were Malay while Chinese, Indians and others accounted 5 (21.7%), 4 (17.4%) and 1 (4.3%) respectively. Only 14 (60.9%) received renal consults and 4 (17.4%) required dialysis support. One patient who required dialysis, died during the admission giving a mortality rate of 4.3%. At time of discharge, 18 (78.3%) had complete renal recovery, 4 (17.4%) developed chronic kidney disease and 1 (4.3%) died before discharge. None of the patients required dialysis support at discharge. Compared to the 12 patients who did not develop AKI, male gender was found to be a risk factor of developing AKI (p¼0.023). There was a suggestion that older patients have a higher preponderance of developing AKI but this did not reach statistical significance. Conclusion: AKI is common in leptospirosis with an incidence of 65.7% but with a favorable outcome where 78.3% have a complete AKI recovery. Male gender appeared to be a risk factor of developing leptospirosis associated AKI.
tertiary cardiothoracic centre in Malysia. The primary outcome was defined as the need for renal replacement therapy after cardiac surgery. The performance of the Cleveland Score was measured by means of their discrimination and calibration. Results: All patient were scored and grouped into 4 risk groups based on the Cleveland model. Overall incidence of AKI-D was 10.3% in our Serdang cohort. The incidence of AKI-D ranged between 4.7% and 80% across the 4 risk categories. When compared to the Cleveland cohort, the incidence of AKI-D in all risk categories were remarkably higher than the 95% confidence interval (CI) of the corresponding AKI-D incidence in the Cleveland Cohort. Discrimination of the model is good, with area under the receiving operator characteristics curve (AU-ROC) of 0.811. Calibration is also good with the p-value of Hosmer and Lameshow test (H-L) >0.05. Conclusion: The Cleveland Score is useful in discriminating between patients with a higher or lower risk of developing AKI-D in our population.
126 VALIDATING CLEVELAND CLINIC SCORE TO PREDICT ACUTE KIDNEY INJURY REQUIRING DIALYSIS AFTER CARDIAC SURGERY Goh, KW1, Goh, BL1, Ibrahim, FH1, Lim, CTS2, Fadhlina, NZ2, Nor, M Arif M3, Loh, WC4, Kasmin, FA1, Lam, KR1, Evi Diana, O5 1 Nephrology Department, Serdang Hospital, 43300 Kajang, Selangor, Malaysia, 2Nephrology Unit, Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia, 43400 UPM, Selangor, Malaysia, 3Cardio thoracic Surgery Department, Serdang Hospital, 43300 Kajang, Selangor, Malaysia, 4 Internal Medicine Department, Fakulti Perubatan dan Sains Kesihatan, Universiti Putra Malaysia, 43400 UPM, Selangor, Malaysia, 5Clinical Research Centre, Serdang Hospital, 43300 Kajang, Selangor, Malaysia
Category: Epidemiology and Outcomes from AKI Presenter: Dr KHENG WEE GOH Keywords: Cardiac Surgery, Acute kidney Injury, Risk prediction Introduction: Acute kidney injury requiring dialysis (AKI-D) is one of
the most feared complication following cardiac surgery, which results in significant mortality and prolonged hospital stay. Patients, especially those with chronic kidney disease (CKD), are often referred to physicians for pre-operative renal assessment and management. A useful and accurate risk score can identify patients at risk for acute kidney injury (AKI) and facilitate preventive strategies preoperative and perioperatively. Several risk scores have been developed for this purpose, but few have been validated in Asian population. Objective: We aim to externally validate the Cleveland Score in our Asian population. The Cleveland Score was chosen as it was developed from a large cohort, has very good discrimination, and has been externally validated in many centres. It also has the advantage of only using preoperative variables, thus allowing risk stratification of patients before the operation. Methodology: A retrospective analysis was conducted on 1741 patients who underwent cardiac surgery during a 5-year period (2011-2015) at a S18
128 CLINICAL VARIABLES IN POOR OUTCOME PATIENT WITH ACUTE KIDNEY INJURY RECEIVING CONTINUOUS VENO VENOUS HEMOFILTRATION THERAPY Hazlina, WM, Asiah, U, Norazinizah, AM, Suhaidarwani, AH, Abdul Wahab, MZ, Visvanathan, R Department of Nephrology, Hospital Kuala Lumpur (HKL), Federal Territory of Kuala Lumpur, Malaysia
Category: Epidemiology and Outcomes from AKI Presenter: Dr WAN HAZLINA WAN MOHAMAD Keywords: Clinical variables, poor outcome, AKI, CVVH Introduction: Acute kidney injury (AKI) is a common complication of
critically ill patients. Patients who received continuous veno venous Kidney International Reports (2017) 2, S1–S41