Reduced kidney function at presentation in unselected acute emergency medical admissions: incidence, outcome and associated factors
Yang, E.; Chalisey, A.; Reschen, M.E.; Shine, B.; Lasserson, D.S.; O'Callaghan, C.A.
Acute Medicine 18(3): 158-164
2019
ISSN/ISBN: 1747-4884 PMID: 31536053 Document Number: 17951
We sought to assess the impact of renal impairment on acute medical admissions and to identify potential contributory factors to admissions involving renal impairment at presentation. In a prospective cohort study, 29.5% of all acute medical emergency admissions had an eGFR <60ml/min/1.73m2 at presentation. Of these, 19.9% had definite chronic kidney disease and 8.4% had definite acute kidney injury. Detailed analysis of a random subset of patients with an eGFR <60ml/min/1.73m2 at presentation demonstrated that the major reasons for admission included falls, dehydration and fluid overload. 46% were on diuretics and 53% were on an ACEI or ARB or both. Gastrointestinal disturbance and recent medication changes were common and diuretic use persisted even with diarrhoea or vomiting.
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