Determinación de los factores asociados a lesión renal aguda severa con indicación de terapia de soporte renal en pacientes críticos de la unidad de cuidados intensivos de una clínica de cuarto nivel en Barranquilla durante el 2024
Cargando...
Fecha
2025
Autores
Flórez Mora, Lizeth Fernanda
Título de la revista
ISSN de la revista
Título del volumen
Editor
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: La lesión renal aguda (LRA) es una complicación frecuente en
pacientes críticos, con alta morbimortalidad y un impacto significativo en la calidad
de vida y los costos del sistema de salud. A pesar de la disponibilidad de terapias
de soporte renal (TSR), la identificación de factores determinantes sigue siendo un
desafío clínico. Objetivo: Determinar los factores asociados a la LRA severa que
indiquen necesidad de TSR en pacientes críticos de una unidad de cuidados
intensivos (UCI) en Barranquilla durante el 2024. Metodología: Se realizó un
estudio observacional, analítico y retrospectivo en una clínica de cuarto nivel,
incluyendo pacientes mayores de 18 años con diagnóstico de LRA severa según la
clasificación KDIGO. Se analizaron variables demográficas, clínicas y bioquímicas,
incluyendo la evolución del gasto urinario, la necesidad de TSR y los desenlaces
clínicos. Resultados: Se incluyeron 49 pacientes, con predominio masculino
(65.31%) y edad media de 65.53 años. Se identificó que la sepsis (55.10%) y el
shock séptico (18.36%) fueron los principales factores de riesgo asociados. En
cuanto a la función renal, el 79.59% de los casos correspondieron a LRA prerrenal,
con predominio de AKIN III (51.02%) al ingreso y persistencia en el 44.90% al quinto
día. La acidosis metabólica, la sobrecarga de volumen y la disminución del gasto
urinario fueron determinantes clave en la necesidad de TSR. Conclusión: La LRA
severa en UCI sigue representando un reto clínico con alta mortalidad y necesidad
de TSR. La identificación temprana de factores como shock séptico, acidosis
metabólica y oliguria persistente puede optimizar la toma de decisiones
terapéuticas, reducir complicaciones y mejorar los desenlaces clínicos.
Introduction: Acute Kidney Injury (AKI) is a common complication in critically ill patients, associated with high morbidity and mortality, significantly impacting quality of life and healthcare costs. Despite the availability of renal replacement therapy (RRT), identifying the key determinants remains a clinical challenge. Objective: To determine the factors associated with severe AKI that indicate the need for RRT in critically ill patients in an intensive care unit (ICU) in Barranquilla during 2024. Methodology: A retrospective, observational, and analytical study was conducted in a tertiary care hospital, including patients over 18 years old diagnosed with severe AKI according to the KDIGO classification. Demographic, clinical, and biochemical variables were analyzed, including urine output progression, RRT requirements, and clinical outcomes. Results: The study included 49 patients, predominantly male (65.31%) with a mean age of 65.53 years. Sepsis (55.10%) and septic shock (18.36%) were identified as the main associated risk factors. Regarding renal function, prerenal AKI accounted for 79.59% of cases, with AKIN III predominating at admission (51.02%) and persisting in 44.90% of cases by day five. Metabolic acidosis, fluid overload, and decreased urine output were key determinants for RRT initiation. Conclusion: Severe AKI in ICU patients remains a major clinical challenge with high mortality and significant RRT requirements. Early identification of risk factors such as septic shock, metabolic acidosis, and persistent oliguria may optimize therapeutic decision-making, reduce complications, and improve clinical outcomes.
Introduction: Acute Kidney Injury (AKI) is a common complication in critically ill patients, associated with high morbidity and mortality, significantly impacting quality of life and healthcare costs. Despite the availability of renal replacement therapy (RRT), identifying the key determinants remains a clinical challenge. Objective: To determine the factors associated with severe AKI that indicate the need for RRT in critically ill patients in an intensive care unit (ICU) in Barranquilla during 2024. Methodology: A retrospective, observational, and analytical study was conducted in a tertiary care hospital, including patients over 18 years old diagnosed with severe AKI according to the KDIGO classification. Demographic, clinical, and biochemical variables were analyzed, including urine output progression, RRT requirements, and clinical outcomes. Results: The study included 49 patients, predominantly male (65.31%) with a mean age of 65.53 years. Sepsis (55.10%) and septic shock (18.36%) were identified as the main associated risk factors. Regarding renal function, prerenal AKI accounted for 79.59% of cases, with AKIN III predominating at admission (51.02%) and persisting in 44.90% of cases by day five. Metabolic acidosis, fluid overload, and decreased urine output were key determinants for RRT initiation. Conclusion: Severe AKI in ICU patients remains a major clinical challenge with high mortality and significant RRT requirements. Early identification of risk factors such as septic shock, metabolic acidosis, and persistent oliguria may optimize therapeutic decision-making, reduce complications, and improve clinical outcomes.
Descripción
Palabras clave
Lesión renal aguda, Terapia de soporte renal, Sepsis, Unidad de cuidados intensivos
