Acute critical illness raises risk of kidney complications

Washington: People with acute critical illness have an increased risk of kidney complications and death, finds a study. “Patients with acute critical illness without apparent underlying renal disease — a group traditionally considered to be at low risk of renal diseases — have clinically relevant long- term renal risks,” wrote Dr. ShihTing Huang and Dr. ChiaHung Kao of Taichung Veterans General Hospital and China Medical University, Taiwan, respectively. Most studies have looked at patients with preexisting kidney disease, while this study looked at data on 33, 613 Taiwanese patients with critical acute illness and no pre- existing kidney disease compared with 63, 148 controls for a medium- term renal outcome. More than half of the patients ( 53 per cent) were above 65 years of age and two- thirds ( 67 per cent) had high blood pressure. Patients who had experienced acute kidney illness were at an increased risk of renal complications, developing chronic kidney disease and end- stage renal disease, with septicemia and septic shock being the strongest risk factors. Of the critically ill patients in the study, 335 developed an end- stage renal disease, with a rate of 21 per 10 000 person- years compared with 4.9 per 10 000 person- years in the control group. Patients who developed chronic kidney disease and end- stage renal disease were at a higher risk of death. The authors have suggested clinicians to monitor kidney functions at 3090 day intervals in patients with acute critical illness without preexisting renal disease and then at least on a yearly basis, afterward. The study has been published in the Canadian Medical Association Journal ( CMAJ). — ANI