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EPIDEMIOLOGICAL PROFILE OF INTRA HOSPITAL DIALYTICAL ACUTE KIDNEY INJURY. THE EXPERIENCE OF A PRIVATE HEALTH CARE PROVIDER, SPECIALIST IN CUSTOMER SERVICE IN ELDERLY PEOPLE IN BRAZIL, IN 2016 Free

INTRODUCTION AND AIMS: Acute dialytic renal failure is a clinical entity, associated with high mortality rates, which often affects patients from the 5th decade of life.Objective - evaluate the epidemiological profile of the patients hospitalized in the Sancta Maggiore network, who were diagnosed with acute renal injury and underwent intra-hospital hemodialysis sessions.

METHODS: a prospective and observational study was performed between January 01 and December 31, 2016, evaluating the epidemiological profile of patients diagnosed with acute renal injury and submitted to intra-hospital dialysis sessions. Age, sex, access, comorbidities, recovery of renal function, diagnosis, hospital discharge and death were evaluated. The AKIN classification was used to define acute injury.

RESULTS: We identified 555 patients admitted to clinical and surgical wards, corresponding to 1,49% of the total number of patients hospitalized in the period, who was submited into hemodialyses and classified as having acute renal failure (lower incidence than that found in the literature - 3.8%), of which 47,9% women and 52,1% men, with a mean age of 75,7 years. The double lumen catheter was the only type of vascular access used; peritoneal dialysis wasn’t indicated for these patients. Systemic arterial hypertension was the main comorbidity presented, affecting 45% of the patients, followed by diabetes (27.8% of the cases). The causes of acute renal injury were: - septic (pneumonia 40%) responsible for 52%, cardiogenic shock 16%, major surgeries 15% and drug induced nephropathy 12%. There was recovery of renal function in 13.3% (lower than that found in the literature) with a 45,05% evolution for outpatient dialysis and the mortality rate was 41,80%. The mortality found was compatible with the data present in the literature, being a clinical entity with a high mortality rate.

CONCLUSIONS: Despite the medical advances of recent years, acute dialysis renal failure, is a pathological entity with a high degree of mortality. Septic conditions, especially pneumonia, contribute to mortality and are among the main causes of renal impairment in patients with acute renal failure.