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논문분류	춘계학술대회 초록집
제목	Clinical Characteristics of Acute Kidney Injury Diagnosed by Decreasing Serum Creatinine Criteria
저자	Harin Rhee
출판정보	2025; 2025(1):
키워드	Acute kidney injury , Definition, Decreasing serum creatinine
초록	KDIGO 2012 defines acute kidney injury (AKI) as an increase in serum creatinine or a decrease in urine output, and a decrease in serum creatinine has not been considered as AKI. However, community-acquired AKI or AKIs in resolving process could be presented in the intensive care unit (ICU) with a decreasing trend of serum creatinine. This study aims to show the clinical significance of decreasing serum creatinine defined- AKI in critically ill patients admitted to the ICU. This is a single-center retrospective study based on the consecutively collected data of ICU-admitted patients. AKI was detected by the electronic medical record system using the following criteria; increase in serum creatinine ≥0.3mg/dL within 48 hours (I-Scr), decrease in urine output <0.5cc/kg/hr sustained more than 6 hours (Oliguria), or decrease in serum creatinine ≥0.3mg/dL within 48 hours (D-Scr). We grouped patients by the AKI defining criteria (Oliguria, I-Scr, D-Scr, and no AKI). Between August 2023 and December 2024, 4553 patients were admitted to the ICU. In all, 27.9% were older than 75 years, 63.9% were male, and 24.9% met AKI during the ICU stay. Among the 1134 patients with AKI, Oliguria, I-Scr, and D-Scr criteria were used in 193 (17.0%), 314(27.7%), and 627(55.3%) of the patients. D-Scr-defined AKI patients had more comorbidities, higher APACHE II score, and more frequent ventilator, vasopressor, or kidney replacement therapy utilization than no AKI. D-Scr-defined AKI patients required longer ICU or hospital stay, higher death, and AKD progression rate at hospital discharge than patients with no AKI (Table 1). Kaplan-Meier curve showed a clear separation of in-hospital mortality between patients with D-Scr-defined AKI and no AKI (Figure 1). More than half of the ICU patients were defined as AKI by D-Scr criteria. D-Scr-defined AKI shares unique characteristics of AKI, requiring special attention.
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