Prediction and severity of hospital-acquired acute kidney injury in patients with and without hypertension and type 2 diabetes

Context: 

The impact and prognosis of acute kidney injury (AKI) change considerably depending on the severity, clinical setting, comorbid factors, and also Geographic location.

 To assess the severity and the risk factors of hospital‑acquired AKI (HA‑AKI) in diabetic and hypertensive patients.

Settings and Design: 

A prospective cohort study was conducted in 2019 with 88 hypertensive and diabetic in hospitalized patients of Distrito Federal.

 A structured questionnaire and Charlson’s comorbidity index (CCI) were the data collection instruments.

Statistical Analysis: 

The data were analyzed using descriptive and inferential methods.

 Hypertensive and diabetic patients were older (70 [62–76] years old, P = 0.001), with a body mass index indicating overweight (26.9 [24.0–31.1] kg/m2 , P = 0.01). AKI predominated among the hypertensive and diabetic patients(30 [52.6%]), and with higher severity stages(Kidney Disease Improving Global Outcomes 2 and 3) (22 [38.6%]). Hypertensive and diabetic patients presented more severity (Charlson >3, P = 0.03), suffered from kidney injury more frequently (30 [52.6%]), and with more severe stages (kidney injury or failure) (22 [38.6%]). Heart disease ([odds ratio (OR) 17.94, confidence interval (CI) 2.23–144.44], P = 0.007) and older age ([OR 1.05, CI 1.01–1.09], P = 0.009) were independent risk factors for predisposition to kidney injury in patients with hypertension and diabetes.

 The hypertensive and diabetic patients were older, with a CCI >3, and evolved to more severe AKI. Heart disease and older age contributed to HA‑AKI. Delays in identifying risk factors may predispose to more severe impairments. Risk assessments support early identification and can encourage professionals in directing, decision‑making, and care management.