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รองศาสตราจารย์์ นพ.ณััฐชััย์ ศรีสวััสดิ์์� 155

Abstract: Acute Kidney Injury in Thailand
Associate Professor Dr.Nattachai Srisawat
Associate Fellow of the Academy of Science,

The Royal Society of Thailand
Acute kidney injury is one of the most common and important problems
in the intensive care unit (ICU). AKI has been reported to occur in as few as
20-50% of patients in ICUs around the world. However, most studies that
have examined the epidemiology of AKI have been conducted in the high-
resource healthcare settings of North America, Northern Europe and Eastern
Asia. AKI is a complex disorder revolving around the interplay of patient
factors and their environments. The phenotype and etiology of AKI may differ
considerably by region and by resources. AKI epidemiology in the SEA region,

a sub-region of Asia comprised of more than 600 million people, have scarcely
been reported in any studies. Thailand, the third most populous country in the
SEA region, and defined as an upper-middle income country by the World Bank,
has virtually no epidemiologic data on AKI, Recently, We conducted the largest
prospective observational study of AKI in SEA. 5,076 patients from 17 ICU
centres across AKI occurred in 2,471 of 4,668 patients (52.9%). Overall,
the maximum AKI stage was Stage 1 in 7.5%, Stage 2 in 16.5% and Stage 3
in 28.9%. In the multivariable adjusted model, we found that older age,
female sex, admission to a regional hospital,medical ICU, high body mass
index, primary diagnosis of cardiovascular-related disease and infectious
disease, higher severity score underlying anemia and use of vasopressors were

all independent risk factors for AKI development. In conclusions, AKI is very
common in Thai ICUs. Identification of risk factors of AKI development will
help in the development of a prognostic scoring model for this population
and should help in decisionmaking for timely intervention, ultimately leading
to better clinical outcomes.

Keywords: Acute Kidney Injury, Epidemiology, Renal Replacement Therapy

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