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Factors associated with acute kidney injury among hypertensive and diabetic patients in medical clinic

Tayse Tâmara da Paixão Duarte

Objective: To verify the factors that contribute to acute kidney injury (AKI) among patients with systemic arterial hypertension (SAH) and diabetes mellitus (DM). Methods: Longitudinal, prospective, quantitative cohort study carried out at the medical clinic of a public hospital in the Distrito Federal, Brazil. Non-probabilistic, convenience sample consisting of 88 patients. A questionnaire was adopted to collect clinical and laboratory data. AKI was defined as an increase in serum creatinine (SCr) ≥ 0.3mg / dL in 48 hours or an increase of 1.5 to 1.9 times its baseline value within seven days, according to the Kidney Disease Improving Global Guidelines (KDIGO). P≤0.05 was considered significant. Results: There was a predominance of males (51.1%), with DM (64.8%) and SAH (64.8%). The altered mean arterial pressure was present in 71.6% of the cases. Most of the patients presented AKI (54.5%), the most severe ones (stage 2 and 3) prevailing, which affected 37.5% of the patients. Among those with SAH and DM (57 patients), advanced age significantly contributed to AKI [70 (62-76) years, p = 0.001], overweight [26.9 (24-31.1) kg / m2, p = 0.01), in addition to the presence of comorbidities such as heart disease (p <0.001) and liver disease (p = 0.001). Conclusion: Among patients with AKI and DM, advanced age, high BMI, comorbidities such as heart disease and liver disease contributed to AKI. The data obtained can support an adequate management of patients with AKI, providing subsidies for additional measures and individualized intervention strategies, in order to prevent progression, chronicity of kidney disease and mortality of these patients.