Effects of acute kidney injury on clinical outcomes in patients with upper gastrointestinal bleeding

Ren Fail. 2016;38(2):176-84. doi: 10.3109/0886022X.2015.1117923. Epub 2015 Dec 1.

Abstract

Aim: Upper gastrointestinal bleeding (UGIB) is a very frequently encountered condition that has a high morbidity and which increases treatment costs. Duration of hospital stay and mortality increases in patients with UGIB complicated by acute kidney injury (AKI). The aim of this study was to reveal risk factors in patients with UGIB developing AKI and to compare clinical outcomes and hospital costs between patients with UGIB developing AKI and those with UGIB not developing AKI.

Material and methods: This retrospective study included 245 patients admitted to the emergency unit and the intensive care unit for internal diseases at Ankara Numune Education and Research Hospital, Turkey.

Results: The difference in mortality rates between the patients with AKI and those without AKI was significant (p < 0.001). The mean duration of intensive care unit stay was 0.2 ± 1.1 days in the patients without AKI (n = 143) and 2.5 ± 5.6 days in the patients with AKI. It was significantly higher in the patients with AKI (p < 0.001). Hospital stay was significantly longer in the patients with AKI than those without AKI, and as severity of AKI increased, hospital stay became considerably longer (p < 0.001). Hospital costs were significantly higher in the patients with AKI than those without AKI, and as severity of AKI increased, hospital costs considerably rose (p < 0.001).

Conclusion: AKI is a condition that lengthens hospital stay, increases hospital costs and creates a burden on health care systems. Detect kidney injury earlier and administering an appropriate treatment can improve clinical outcomes in patients with UGIB developing AKI.

Keywords: Acute kidney injury; RIFLE criteria; hospital costs; mortality; upper gastrointestinal bleeding.

MeSH terms

  • Acute Kidney Injury / etiology*
  • Aged
  • Female
  • Gastrointestinal Hemorrhage / complications*
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Length of Stay
  • Male
  • Retrospective Studies
  • Treatment Outcome