Clinical Characteristics and Risk Factors of Acute Kidney Injury in Patients with Acute Alcohol Intoxication

Korean Journal of Nephrology 2011;30(1):26-34.

Jihan Yu, Yeongsin Shin, Hyun Ju Jung, Yu Seon Yun, Hyun Gyung Kim, Young Soo Kim, Sun Ae Yoon, Yong Soo Kim, and Young Ok Kim

Departments of Internal Medicine1 and Anesthesiology & Pain Medicine²
College of Medicine, The Catholic University of Korea, Seoul, Korea

원저 : 급성 알코올중독 환자에서 급성 신손상의 임상적 특성

유지한1, 신영신1, 정현주2, 윤유선1, 김현경1, 김영수1, 윤선애1, 김용수1, 김영옥1

가톨릭대학교 의과대학 내과학교실1, 마취통증의학교실2

Abstract

Purpose: Acute alcohol intoxication (AAI) causes various complications such as electrolyte imbalance, alcoholic ketoacidosis (AKA), rhabdomyolysis, and acute kidney injury (AKI). Although there have been some reports about AKA and rhabdomyolysis, AKI due to acute alcohol intoxication is rarely reported. Methods: We retrospectively evaluated the medical records of 371 patients with AAI between January 2004 and May 2010 in Uijeongbu St. Mary’s Hospital. We compared the clinical findings, morbidity and mortality rate between AKI and normal kidney function (NKF) groups. Results: Of the total 371 patients with AAI, AKI occurred in 107 patients (28.8%). The peak serum creatinine level in AKI patients was 2.9±1.9 mg/dL. Thirteen of the 107 patients (12.1%) received renal replacement therapy. AKI group had higher incidence of decreased mentality (29.0% vs 16.3%, p= 0.006), dyspnea (11.2% vs 4.9%, p=0.029) and hypotension (66.0% vs 41.7%, p<0.001), and lower incidence of gastrointestinal bleeding (22.4% vs 34.8%, p=0.019), compared to NKF group. The AKI group also had higher incidence of ketoacidosis (78.5% vs 28.8%, p<0.001), rhabdomyolysis (19.6% vs 4.2%, p<0.001), and pneumonia (22.4% vs 8.0%, p<0.001), compared to NKF group. The length of ICU stay was longer (7.4±10.8 vs 4.1±6.1 days, p=0.003) and the mortality rate was higher (17.8% vs 2.3%, p<0.001) in AKI group. Conclusion: This study demonstrated that incidence of AKI in patients with AAI was 28.8% and AKI was associated with high morbidity and mortality. And multivariate analysis demonstrated that independent risk factors of AKI were ketoacidosis and increased serum osmolality.

Key Words: Acute kidney failure, Alcohol-induced disorders, Mortality