Evaluation of Geographic and Clinical Differences of Acute Kidney Injury in Intensive Care Unit Patients in Turkey Running Head: AKI cases in intensive care units in Turkey

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Background: This is a subgroup analysis of previously reported study. The aim of this study to evaluate the acute kidney injury cases in intensive care unit (AKI-ICU) if there are differences in etiology, clinical courses, treatment and outcome in the different part of the country. Methods: This subgroup analysis was carried on by Acute Kidney Injury Working Group of Turkish Society of Nephrology. Demographical and clinical data of AKI patients at the time of diagnosis, at the first week and first, third and sixth months were evaluated to determine patient and kidney survival and factors may be associated with prognosis. Results: 126 AKI-ICU patient; 73 (57.9%) were men, the median age was 69 (IQR: 61.5– 79). Prerenal causes were more frequent (80%), namely dehydration, heart failure and sepsis.64.3% of patients had one renal etiology, nephrotoxin exposure being the most frequent (25%). 45,2% of patients needed kidney replacement therapy and 37,3% intermittant hemodialysis were performed. Continuous kidney replacement therapy were preferred only in the Marmara region. The regions were different significantly regarding the frequency and types of these treatments. At the sixth month of diagnosis, 17% of patients had complete, 19% had partial recovery, while end stage kidney disease ensued in 2% and 61% of patients died. Death rate was higher but not statistically significant in patients from south Anatolian Region. Conclusions: The patients with dehydration, heart failure and sepsis and, nephrotoxin exposure should be alert. Being aware of the characteristics of AKI patients in their country would help to prevent developing AKI and treating better.