Original Investigations: Pathogenesis and TreatmentHospital-acquired renal insufficiency☆
Section snippets
Methods
Four thousand six hundred twenty-two consecutive patients admitted to the medical and surgical services of Rush Presbyterian-St Luke's Medical Center between February 29, 1996, and June 30, 1996, were followed up prospectively for the development of worsening renal function. Renal insufficiency was defined as an increase in serum creatinine level of 0.5 mg/dL for patients with a baseline serum creatinine level of 1.9 mg/dL or less, 1.0 mg/dL for patients with a baseline level of 2.0 to 4.9
Risk factors for renal insufficiency
Four thousand six hundred twenty-two patients were admitted to the medical and surgical services during the 4-month period (Table 1).
NOTE. Values Empty Cell All Patients (n = 4,622) Patients With Renal Insufficiency (n = 332) P Men 2,102 180 (8.6) Women 2,515 150 (6) 0.05 Age (y) 20-39 917 34 (3.7) 40-59 1,417 80 (5.6) 60-79 1,763 152 (8.6) >80 517 55 (10.6) <0.001 Lowest creatinine (mg/dL) ≤1.2 3,232 172 (5.3) >1.2 959 151 (15.7) <0.05 Ethnic group White 2,248 180 (8) Black 1,687 106 (6.3) Hispanic 352 28 (8) <0.05
Discussion
The incidence of HARI varies depending on how this entity is defined by the investigator. We used criteria that allowed us to study mild degrees of renal insufficiency, rather than only those patients requiring dialysis because there is evidence that relatively small increases in serum creatinine level are associated with large increases in mortality, even after correction for comorbid conditions.1, 2, 4
Acute deterioration in renal function occurred in 7.2% of the 4,622 patients admitted to the
Acknowledgements
The authors thank Kimberly Traylor-Dixon for help in manuscript preparation.
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Address reprint requests to Susan Hou, MD, Renal Section, Bldg 102, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153. E-mail: [email protected]