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Background: Pregnancy Related Acute Kidney Injury (PRAKI) is a major cause of maternal and foetal morbidity and mortality in developing countries. The incidence has declined due to improvements in reproductive health but it is still associated with significant perinatal mortality and maternal morbidity. It may be due to decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions encountered during pregnancy. Our study aims at determining the predisposing factors and causes of AKI during pregnancy and its impact on maternal and foetal outcome.Methods: A retrospective cohort study over a period of 5 years was conducted on pregnant women with AKI as per inclusion and exclusion criteria. The detailed history, events, mode of delivery, cause leading to AKI, management, hospital stay, maternal and foetal outcome were studied in detail and evaluated. These patients were classified according to RIFLE criteria and were followed up for hospital stay and residual morbidities.Results: The incidence of PRAKI in the study was 0.07% (36 out of 50,735 deliveries) and among obstetric ICU patients, it was 6.8%. Most of the majority of the cases were unbooked (66.7%) and multipara (61.1%). Maternal morbidity was seen in 66.7% and mortality was 27.8%. Poor foetal outcome was seen in 44.4%.Conclusions: Haemorrhage is the most common cause of PRAKI, followed by toxaemia of pregnancy and sepsis. Early detection and meticulous management of haemorrhage, hypertension and sepsis reduce the incidence of PRAKI and associated maternal mortality.
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Introduction: Intra-abdominal hypertension (IAH), asustained and repeated steady state rise in intra-abdominalpressure (IAP) above 12 mmHg, was reported as a hiddencause contributing to morbidity and mortality in criticallyill patients. This study was aimed to find out the possiblerelationship between IAH and acute kidney injury (AKI) inICU patients.Material and methods: Prospective cohort study wasconducted among patients admitted in medical and surgicalICU. Consecutive patients coming under the inclusioncriteria were selected and IAH was measured using pressuretransducer technique. IAP was measured at the time ofadmission, at 24 hours, 48hours and also at the end of 72hours.Other parameters were collected based on a standard proformaprepared.Results: Eighty patients were included in our study, of which24 patients had IAH. Mean age in patients with IAH wasobtained as 63.08 ± 12.37 years with a male predominance.Maximum patients were belonging to age group of 61-70yrs (25%), 9 patients were below 40 yrs and 14 patientswere above 81yrs. Mean IAP was calculated to be 11.65 ±3.15. Only 9 patients were in grade IV (11.3%). Risk factorsassociated were found to be ascites, upper GI bleed andmetabolic encephalopathy. IAH and AKI were found to besignificantly correlated (odds ratio=2.666 with CI 0.98-7.25).Conclusion: Rising intra-abdominal pressure is found to havehigher incidence of renal failure than those with establishedIAH. IAH has been found to be a clinically significant riskfactor for development of AKI in ICU patients.
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Background: Acute Kidney Injury (AKI) is one of the major cause of in-hospital mortality rates globally. The current study was conducted to study the etiological profile, severity and management of acute kidney injury.Methods: The study was a prospective observational study, conducted in the department general medicine, Dhanalakshmi Srinivasan Medical college and Hospital, Permabalur, Tamil Nadu. The study population included all the patients admitted to Intensive Care Unit (ICU) with acute Kidney injury (AKI) between January 2015 to December 2016. All the study participants were recruited to the study by convenient sampling. Descriptive analysis was carried out by frequency and proportion for categorical variables.Results: A total of 100 subjects were included. Participants were almost uniformly distributed in each of a decadal age group till above 60 years. Males (57%) were slightly higher than females (43%). Oliguria was present in 88% of the study population. The most common etiology was acute diarrhoeal disease (44%), followed by multiple infections in 12% and Sepsis in 10% of the subjects. As per RIFLE criteria 46% participants were at risk, 26.0% had injury, 28% had failure. All at risk people were treated conservatively, among injury category, 38.5% were treated by haemodialysis and 3.84% by peritoneal dialysis. In failure group, 60.71% and 3.57% were treated by haemodialysis and peritoneal dialysis respectively.Conclusions: Acute kidney Injury (AKI) can be a consequence of varied aetiologies and all the age groups and both the genders at risk of developing it. RIFLE criteria may be a useful tool in guiding the management
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Objectives: We aim to report here a series of cases developing AKI after scorpion stings. Patients and Methods: During a period of 25 years that is; from January 1990- December 2014 all the patients coming to Sindh Institute of Urology and Transplantation, with AKI after scorpion sting are included in study. AKI was defined according to RIFLE criteria and Scorpion sting was labeled on history of person stung by scorpion. Results: During studied period 18 patients were brought with scorpion sting. Mean age of patients was 29.22±18.48 years, 7 were male and 11 females. Mean duration of insult was 8.94±4.12 days. Sixteen out of 18 patients were either oliguric or anuric on presentation. Uremia was advanced on arrival with mean urea of 324.38±116.82 and creatinine of 11.8±4.30 mg/dl. Hyponatremia was a common finding with mean sodium of 129.16±8.76 meq/l. Extensive tissue damage at site of sting observed in many patients and mean values for LDH and CK were 2349.71±3499.15 and 3116.23±5468.22 U/L respectively. Hemodialysis required in all patients. Complete renal recovery seen in 13 patients, 2 expired and 3 discharged from hospital in partial state of recovery and never turned for follow up. Conclusion: Scorpion sting is major health problem in many parts of our country, in majority it takes a benign course but in some may affect multiple organs and result in death, especially if initial treatment is delayed.
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Introduction: Acute kidney injury (AKI) is a frequent and potentially fatal complication in infectious diseases. The aim of this study was to investigate the clinical aspects of AKI associated with infectious diseases and the factors associated with mortality. Methods: This retrospective study was conducted in patients with AKI who were admitted to the intensive care unit (ICU) of a tertiary infectious diseases hospital from January 2003 to January 2012. The major underlying diseases and clinical and laboratory findings were evaluated. Results: A total of 253 cases were included. The mean age was 46±16 years, and 72% of the patients were male. The main diseases were human immunodeficiency virus (HIV) infection, HIV/acquired immunodeficiency syndrome (AIDS) (30%), tuberculosis (12%), leptospirosis (11%) and dengue (4%). Dialysis was performed in 70 cases (27.6%). The patients were classified as risk (4.4%), injury (63.6%) or failure (32%). The time between AKI diagnosis and dialysis was 3.6±4.7 days. Oliguria was observed in 112 cases (45.7%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher in patients with HIV/AIDS (57±20, p-value=0.01) and dengue (68±11, p-value=0.01). Death occurred in 159 cases (62.8%). Mortality was higher in patients with HIV/AIDS (76.6%, p-value=0.02). A multivariate analysis identified the following independent risk factors for death: oliguria, metabolic acidosis, sepsis, hypovolemia, the need for vasoactive drugs, the need for mechanical ventilation and the APACHE II score. Conclusions: AKI is a common complication in infectious diseases, with high mortality. Mortality was higher in patients with HIV/AIDS, most likely due to the severity of immunosuppression and opportunistic diseases. .
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Female , Humans , Male , Middle Aged , Acute Kidney Injury/mortality , APACHE , Acute Kidney Injury/etiology , Cohort Studies , Critical Illness/epidemiology , Hospital Mortality , Intensive Care Units , Retrospective StudiesABSTRACT
Objetivo: Estudiar la incidencia de Insuficiencia renal aguda (IRA) en el postrasplante hepático, sus factores de riesgo y evaluar mortalidad en la internación y al año postrasplante. Material y métodos: Se realizó un análisis retrospectivo de 157 pacientes trasplantados hepáticos mayores de 18 años en el período comprendido entre diciembre de 2001 a mayo 2011. Fue analizada la función renal dentro de las 48 hs. previas al trasplante y postrasplante durante la internación. Se definió IRA al aumento de creatinina sérica en 1.5 veces el valor basal. Resultados: la incidencia de IRA postrasplante hepático fue del 33% (n=53). En el análisis multivariado la edad y la diabetes mostraron una asociación significativa con la presencia de IRA postrasplante hepático. La estadía hospitalaria entre los pacientes del grupo IRA promedió los 20 días (15-31) versus 14 días (11-23) del grupo no IRA (p=0,009). La mortalidad hospitalaria del grupo IRA fue de 16.9% (n=9) versus 3.8%(n=4) del grupo no IRA (p=0.005). La mortalidad al año postrasplante del grupo IRA fue de 26.4%(n=14) versus 7.6%(n=8) del grupo no IRA (p=0.001). Conclusión: la IRA en el postrasplante hepático es una complicación frecuente que está asociada a un aumento de la estadía hospitalaria, mortalidad a corto plazo y menor sobrevida al año postrasplante. La edad y la diabetes fueron factores independientes asociados a la presencia de IRA postrasplante hepático.
Objectives: Assessing: a).- The incidence of Acute Kidney Injury (AKI) in post-liver transplantation and its risk factors; b).- Mortality during hospitalization and one year after the transplantation. Materials and Methods: A retrospective analysis in 157 liver transplantation patients over 18 years of age was conducted from December of 2001 to May of 2011. Kidney function was assessed within 48 hours prior to the transplantation and during hospitalization after the transplantation. AKI was defined as a 1.5-fold serum creatinine increase from baseline. Results: AKI incidence following liver transplantation was 33% (n=53). In the multivariate analysis, age and diabetes showed significant association with the presence of AKI following liver transplantation. Average length of stay in hospital among patients in the AKI group was 20 days (15-31) versus 14 days (11- 23) in the non-AKI group (p=0.009). Hospital mortality in the AKI group was 16.9% (n=9) versus 3.8% (n=4) in the non-AKI group (p=0.005). Mortality one year following transplantation in the AKI group was 26.4% (n=14) versus 7.6%(n=8) in the non-AKI group (p=0.001).Conclusion: AKI following liver transplantation is a common complication which is associated withan increased stay in hospital, short-term mortality, and lower survival one year after transplantation. Age and diabetes were independent factors associated with the presence of AKI following liver transplantation.
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Humans , Acute Kidney Injury , Liver Transplantation/adverse effectsABSTRACT
Objective To evaluate the value of the RIFLE criteria of acute kidney injury (AKI) for predicting the incidence and prognosis in critically ill patients and to identify the risk factors associated with the outcomes of those patients.Methods All ICU patients admitted over three years and 6-month period were retrospectively studied at Subei People's Hospital.Based on RIFLE criteria,AKI patients were diagnosed and classified into four groups:NAKI (non-AKI),R (risk),I (injury),F (failure)groups.Results (1) AKI occurred in 404 of the 2472 patients (16.3％) during their ICU stay.The mean age of the patients was (61.4 ± 17.4) years.Infectious disease,pulmonary disease,neurological disease and trauma were the major cause of AKI.(2) Mortality in the ICU was much higher in patients with AKI than in patients without AKI (47.3％ vs.23.0％,P ＜ 0.05).The mortality rate was 35.6％ in R group,48.9％ in I group and 60.6％ in F group.(3) The logistic regression suggested that MODS and septic shock were the independent risk factors of AKI,but continuous renal replacement therapy (CRRT) are the independent protective factor of AKI.Conclusions In these ICU patients,AKI is associated with increased hospital mortality.The RIFLE classification is a simple and useful diagnosis tool to detect and stratify the severity of AKI and aid in predicting outcome of patients.
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Objective The mortality rate of the children after surgical repair of congenital heart disease associated with acute renal injure has been reported to be 30％-79％.Peritoneal dialysis is the common treatment method for those patients,but the optimal time to initiate peritoneal dialysis is still controversial.The aim of this study was to investigate the clinic outcome of early peritoneal dialysis to the children following cardiac surgery.Methods We performed a retrospective chart of children following cardiac surgery from January 2008 to December 2009.The total number was 4561,62 of them were performed PD treatment.Data on the PD treatment children were collected from pre-operation to hospital discharge.Early peritoneal dialysis group was defintes as PD initiated at operation room or the interval between the end of operation to starting peritoneal dialysis less than 3hrs.the others were traditional PD group.Results The whole PD treatment rate was 1.36％,15 patients died.The mortality were 10.71％ (3/28) in early PD and 35.29％ (12/34) in conditional PD group respectively (P =0.036).2 patients were met RIFLE(risk,injury,failure,loss,and end-stage renal disease,RIFLE)classification as failure grade in early PD group while 10 patients in traditional PD group (P =0.001).After PD treatment 24hrs,the Vasoactive-Inotrope Scores and serum creatinine values were much lower in the early PD group children than those in the traditional PD group[(19.00 ±2.39) vs(37.00±5.22),P=0.002;(50.51 ±21.84) vs(130.13±76.09),P=0.001)].Conclusion This study shows that early PD can prevent the children after congenital heart surgery to develop AKI,and reduce the severity of the clinic status.Early intervention with PD is associated with low mortality.
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Acute kidney injury (AKI) is characterized as acute decline of renal function. AKI is frequently combined in hospitalized patients and worsen the outcome of the affected patients. Recently new criteria named RIFLE and AKIN were made to define AKI more uniformly. Recent studies with RIFLE/AKIN showed that even less severe forms of AKI are associated with reduced survival and worse outcome. In this review, we will discuss on the definition, Incidence, Etiology and outcome of AKI.
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Humans , Acute Kidney Injury , Incidence , KidneyABSTRACT
Introducción: la enfermedad renal aguda (ERA) se presenta en el postrasplante de hígado con una incidencia que varía de 12-64%, con una mortalidad intrahospitalaria asociada de 40-67%. Este estudio utiliza los criterios RIFLE para analizar el efecto del esquema inmunosupresor con inhibidores de la calcineurina en la aparición de ERA en los primeros quince días postrasplante de hígado. También evalúa el protocolo de introducción tardía y progresiva de los medicamentos inhibidores de la calcineurina (CNi) como estrategia para disminuir la incidencia de ERA postrasplante. Métodos: estudio analítico de cohortes de 163 pacientes con trasplante de hígado. Resultados: ciento sesenta y tres pacientes cumplieron con los criterios de inclusión del estudio con un promedio de edad de 51 (46-56) años. De éstos, sólo 11 (6.74%) presentaron ERA postrasplante. Ciclosporina fue administrada a 126 (77.3%) de los pacientes trasplantados y tacrolimus a 21 (12.88%). Inmediatamente después del trasplante los pacientes fueron clasificados en dos grupos: pacientes con riesgo alto de desarrollar ERA y pacientes sin problemas renales. A los primeros se les inició el CNi a partir del tercer día postrasplante y a los últimos entre seis y 18 horas después del trasplante, a una dosis que se aumentó gradualmente Conclusiones: la introducción tardía y progresiva de los CNi podría ser una estrategia efectiva para disminuir la incidencia de ERA en el postrasplante de hígado (Acta Med Colomb 2011; 36: 130-134).
Background: acute renal disease (ARD) occurs in liver transplantation with an incidence ranging from 12 to 64%, with an associated hospital mortality of 40 to 67%.This study used the RIFLE criteria to analyze the effect of an immunosuppressive regime including calcineurin inhibitors (CNi) in the development of ARD in patients with liver transplantation. It also assesses the protocol and progressive late introduction of CNi as a strategy to reduce the incidence of posttransplant ARD Methods: cohort analytic study of 163 patients with liver transplantation Results: 163 patients met the study inclusion criteria with an average age of 51 (46-56) years. Of these patients, only 11 (6.74%) had ARD transplantation. Cyclosporine was administered to 126 (77.3%) of tacrolimus in transplant patients and 21 (12.88%). Immediately after the transplant, patients were classified into two groups: patients with high risk of developing ERA and patients without kidney problems. At first they were introduced to the CNi from the third day after transplantation and the last six to 18 hours after the transplant, a dose that was gradually increased Conclusions: late and gradual introduction of CNi could be an effective strategy to reduce the incidence of acute renal disease in liver transplantation (Acta Med Colomb 2011; 36: 130-134).
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Objective To analyze the efficacy of continuous veno-venous hemofiltration (CVVH) for patients with wasp sting-induced multiple organ dysfunction syndrome (MODS) at different phases according to RIFLE criteria. Methods The clinical data of 61 patients with wasp sting-induced MODS, who were treated in Chengdu General Hospital, Southwest Hospital and Xinqiao Hospital during Jan. 2006 to Dec. 2010, were retrospectively analyzed. Sixteen patients who were not treated with CVVH were taken as controls. Another 45 patients with acute kidney injury(AKI) were divided into 3 groups: group A (AKI I), group B(AKI II) and group C (AKI III) according to the RIFLE criteria; the timing of CVVH was analyzed according to different phases of AKI. The mortality rate in hospital, length of ICU stay, duration of total mechanical ventilation, length of CVVH, and the intervals between wasp sting and CVVH were compared among different groups. Their APACHE II scores, sequential organ failure assessment (SOFA) scores, serum interleukin-6 (IL-6), oxygenate index, serum creatinine (Cr), and mean arterial pressure(MAP) were compared before and 24 h after CVVH. Resutts (1)The mortality rate in the control group was significantly higher than that in therapeutic group(P0.05), but serum IL-6 in group B was significantly higher than that in group A(P0.05). Conclusion CVVH is an effective treatment for patients with wasp sting-induced MODS. RIFLE criteria can help to guide the timing of CVVH. CVVH can remarkably improve the prognosis of patientswith phase I and II AKI afterwasp sting-induced MODS, with the best efficacy seen in patient with phase I AKI.
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Acute renal failure means that the word does not contain a mild kidney injury. In addition, the criteria for acute renal failure per researcher are different, and it is difficult in interpreting the results of research on acute renal failure. Therefore, rather than acute renal failure, a new term "acute kidney injury" meaning to include all the levels of injury is introduced. In 2002, to diagnose by means of serum creatinine, glomerular filtration rate and urine output, a detailed classification of acute kidney injury, the RIFLE criteria has been proposed. In 2007, the RIFLE criteria by transforming, AKIN criteria has been proposed. The pediatric RIFLE criteria for children has also been proposed. The author reviews here these criteria by comparing them.
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Child , Humans , Acute Kidney Injury , Creatinine , Glomerular Filtration Rate , KidneyABSTRACT
Objective To investigate the prognosis of children with acute kidney injury(AKI)treated with peritoneal dialysis(PD)following cardiopulmonary bypass.Methods A retrospective study of 46 children aged under 14 years old with AKI treated by using PD following cardiopulmonary bypass from Jan.2006 through Dec.2010.All of them were divided into three groups,namely group A(AKI Ⅰ),group B(AKI Ⅱ)and group C(AKI Ⅲ)according to the stratification of RIFLE criteria.The timing of PD was depended on the phase of AKI.The ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD were compared among three groups.Their APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,serum interleukin-6(IL-6),oxygenate index,serum creatinine,and mean arterial pressure were also compared between before PD and after PD for 48 hours.One-way ANOVA was used for statistical analysis between different phases of AKI.Data got before PD and after PD for 48 hours were analyzed with paired Student' s t-test.Results The APACHE Ⅱ score,SOFA score and serum IL-6 before PD were higher in patients with phase Ⅲ of AKI than those in patients with phases Ⅰ and Ⅱ of AKI(P ＜ 0.01).There were no significant differences in APACHE Ⅱ score and SOFA score between patients with phases Ⅰ of AKI and patients with phase Ⅱ of AKI before PD(P ＞0.05),but serum IL-6 before PD,ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD in patients with phase Ⅱ of AKI were higher or longer than those in patients with phase Ⅰ of AKI(P ＜ 0.01).After PD for 48 hours,APACHE Ⅱ score,SOFA score,serum IL-6,oxygenate index,serum creatinine and mean arterial pressure improved insignificantly in patients with phase Ⅲ of AKI(P ＞0.05),but those were improved significantly in patients with phases Ⅰand Ⅱ of AKI(P ＜ 0.05),while serum IL-6 in patients with phase Ⅱ of AKI was still higher than that in patients with phase Ⅰ of AKI(P ＜ 0.01).Conclusions Therapeutic effect of PD on children with AKI following CPB is better if PD is started in the phases Ⅰ and Ⅱ of AKI,especially in the phase Ⅰ of AKI.The RIFLE criteria and IL-6 are useful guidance to the assessment of patients' illness.
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Objective To analyze morbidity and prognosis of acute kidney injury (AKI) in patients with acute leukemia after myeloablative allogenetic hematopoietic stem cell transplantation (HSCT).Methods Renal function and related clinical data in 66 patients receiving myeloablative alloHSCT were retrospectively analyzed.Renal function was evaluated by RIFLE criteria,which defines AKI as three grades of severity-risk (AKI-R),injury (AKI-I) and failure (AKI-F).Results Thirtyseven recipients (56.1%) developed AKI at a median of 29 days after allo-HSCT,including AKI-R(19 recipients,28.8 %),AKI-I (11 recipients,16.7 %),AKI-F (7 recipients,10.6 %).Compared with baseline value,serum creatinine level in the recipients was significantly increased at the 21st day after transplantation (P＜0.05).During 100 days after HSCT,the morbidity of AKI-F in recipients with HVOD and without HVOD were respectively (55.56 ± 22.22)% and (9.01 ± 4.75)% (P＜0.01).The morbidity of AKI in recipients with or without increased total bilirubin was respectively (68.75 ± 24.54)% and (8.38 ± 4.17)% (P＜0.01).The morbidity of AKI in recipients with or without increased CsA concentration was respectively (66.67 ± 10.29) % and (44.44 ± 8.28) % (P＜0.05).100-day survival rate in recipients after myeloablative allo-HSCT without AKI,with AKI-R,AKI-I and AKI-F was respectively (89.66 ± 5.66) %,(83.88 ± 8.54) %,(81.82 ± 11.63) % and (42.86 ± 18.7) % (P＜0.05).Conclusion AKI is one of the main complications in patients with acute leukemia after myeloablative allo-HSCT.The influence of different class AKI on the mortality was different.The earlier diagnosis,prophylaxis and treatment of AKI by the RIFLF criteria might increase the survival rate in recipients with HSCT.
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Objective To assess the incidence,risk factors and mortality of acute kidney injury(AKI)in patients with chronic myelogeneous leukemia(CML)after myeloablative allogenetic hematopoietic stem cell transplantation(HSCT). Methods Renal function in 93 CML patients undergone myeloablative allo-HSCT was retrospectively analyzed by the RIFLE criteria. Results Thirty-nine patients (41.9%) developed AKI at a median of 40 days after allo-HSCT, including 24 AKI-R patients(25.8%), 10 AKI-I patients(10.8%) and 5 AKI-F patients (5.4%). The morbidity of AKI in patients with ≥Ⅲ acute graft-versus-host disease (aGVHD) and without ＜Ⅲ GVHD was (81.82±11.63)% and (36.59±5.32)% (P=0.0037)rospectively. The morbidity of AKI in patients with increased total bilirubin and without increased total bilirubin was (72.73±13.43)% and (37.04±5.37)%(P=0.0192) respectively. ≥Ⅲ aGVHD was peor-prognostic factor of AKI and RR was 2.773 [95%CI (1.073-7.167), P=0.035]. RR of AKI-I and AKI-F in patients with ≥Ⅲ aGVHD was 6.320195%CI (1.464-27.291), P=0.013]. The mortality within 100 days after allo-HSCT of patients with AKI was significantly different as compared to patients without AKI (P=0.001). Six-mouth survival rates of different class AKI patients after myeloablative allo-HSCT were (86.96±7.02)% (AKI-R), (70.00±14.49)% (AKI-I), 0 (AKI-F) (P=0.000)respectively. Conclusions AKI is one of the main complications in CML patients after myeloablative allo-HSCT. ≥Ⅲ aGVHD and increased total bilimbin are poor-prognostic factors of AKI, and higher morbidity of AKI-I and AKI-F can be found in patients with ≥Ⅲ aGVHD. With the deteriorated AKI, 6-month survival is decreased. RIFLE criteria is sensitive to the early diagnosis of renal function. Moreover RIFLE can monitor the progression of AKI and predict the clinical outcome.
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Objective To investigate the protection of renal function and the prevention of acute renal failure (ARF) in patients with malignant obstructive jaundice in perioperative period of radical resection. Methods A series of clinical interventions had been taken since 2004 in our treatment team, including control of endotoxemia, depression of biliary tract before operation, maintenance of adequate effective blood volume, nutritive support, administration of mannitol and low dose of furosemide, and avoidance of disseminated intravascular coagulation. The incidence of perioperative ARF in 206 patients with malignant obstructive jaundice who had been radically resected from 2000 to 2007 was retrospectively studied, and the RIFLE criteria was used for ARF classification. This study was progressed in two periods. The first one was from Jan. 2000 to Dec. 2003, and the second one was from Jan. 2004 to Dec. 2007. Results After 2003, the proportion of radical resection rose from 44.8% to 57.1% (P
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1 ml/kg)and the ICU stay.Results The hospital mortality of AKI phaseⅢwas significantly higher than that of AKI phaseⅠorⅡ(P