Investigation of the impact of laboratory parameters of patients with acute kidney injury on in-hospital adverse events

Introduction and Objective: Acute kidney injury (AKI) is a clinically significant condition with high morbidity and mortality rates. It is a frequently encountered condition with various etiological factors, many of which are potentially preventable/treatable. Timely diagnosis and appropriate treatment approaches are crucial for patients with AKI. Laboratory parameters play a vital role in early diagnosis and staging. Our study aims to investigate the impact of routine laboratory parameters obtained from patients diagnosed with acute kidney injury in the emergency department on adverse events such as admission to the intensive care unit, length of hospital stay, need for dialysis, in-hospital and 6-month mortality. Materials and Methods: The study was conducted retrospectively in the emergency department between January 01, 2021 and June 30, 2022. Ethical approval was obtained before the study commenced. Patients aged 18 and over who presented to the emergency department were included. The diagnosis of acute kidney injury was made according to the AKIN staging criteria. Routine blood samples obtained from patients at the time of their initial presentation to the emergency department were retrospectively reviewed. Parameters including complete blood count, biochemistry (BUN, creatinine, GFR, AST, ALT, total bilirubin, glucose, sodium, potassium, calcium), CRP and blood gas values (pH, bicarbonate, pCO2, pO2, saturation, lactate, sodium, potassium, chloride, ionized calcium, hemoglobin, base excess, anion gap) were examined. Patients' discharge status, ward admission, intensive care unit admission, length of hospital stay, dialysis status, survival status were evaluated. Results: Our study was conducted with 324 patients diagnosed with acute kidney injury in the emergency department. Among the parameters evaluated according to in-hospital survival, statistically significant differences were found in creatinine, BUN, GFR, AST, calcium, CRP, pH, bicarbonate, lactate and base excess values(respectively p<0,001, p<0,001, p<0,001, p=0,001, p=0,001, p=0,001, p=0,006, p=0,012, p=0,001, p=0,009). Regarding six-month mortality; creatinine, BUN, GFR, AST, calcium, CRP, total bilirubin and sodium values were found to be statistically significant (respectively p=0,001, p<001, p<001, p=0,001, p<001, p<0,001, p=0,015, p=0,034), while pH, bicarbonate and base axcess were not (respectively p=0,63, p=0,095, p=0,181). Conclusion: Timely diagnosis and appropriate treatment approaches are crucial for patients with acute kidney injury. It is particularly important to investigate how markers are affected, especially to control underlying causes and reduce risk factors.