OBJECTIVES: This study evaluates the clinical characteristics and potential correlates associated with AKI in critically ill adults.

METHODS: A retrospective cohort study of 322 patients was performed in adult critically ill patients from February 1 to August 30, 2020. Patients excluded were long-term care patients, extreme outliers (> 4 standard deviations of ICU length of stay), a history of renal replacement therapy or kidney transplantation. AKI status was determined by both SCr- and UO-based methods based upon The Kidney Disease Improving Global Outcomes (KDIGO) classification system.

RESULTS: Overall, 322 patients were evaluated, of which 155 (48.1%) experienced AKI. The AKI cohort had significantly lower eGFR, 59.4 (22.4-89.8, p < 0.05) when compared to non-AKI patients. Hispanic ethnicity had higher rates of AKI 24, (15%) when compared to non-AKI patients. In the AKI cohorts, the most commonly prescribed medication classes were analgesics/sedatives, anti-infectives, and intravenous fluids. Medication classes such as anti-infectives and diuretics were significantly associated with AKI incidence on day 2 of ICU admission (OR’s): 2.54 (1.27-5.20, p-value < 0.05) and 0.30 (0.11-0.77, p-value < 0.05), respectively. Charlson Comorbidity Index, age, and BMI were significantly associated with AKI incidence on day 2 of ICU admission (OR’s): 1.25 (1.05-1.49, p-value < 0.01) and 1.01 (1.00-1.02, p-value < 0.05), and 1.03 (1.00-1.07, p-value < 0.05) respectively.

CONCLUSIONS: Incorporating medication use data with clinical information improves AKI risk stratification. Medication classes further impact the risk of developing AKI, necessitating the need for early recognition of high-risk pharmacotherapies to mitigate potential risk.