RESUMEN
Antecedentes: La lesión renal aguda (LRA) representa una complicación
frecuente en pacientes hospitalizados, especialmente en servicios de urgencias, y
se asocia con mayor morbimortalidad y estancia hospitalaria prolongada. En
entornos
clínicos
críticos,
diversos
factores
como comorbilidades
cardiovasculares, infecciones severas y uso de fármacos nefrotóxicos han sido
vinculados con su aparición y progresión. Sin embargo, existe limitada evidencia
local sobre su comportamiento clínico y factores asociados en pacientes
mexicanos. Objetivo: Identificar los factores de riesgo asociados al desarrollo y
severidad de la lesión renal aguda en pacientes adultos hospitalizados en el
servicio de urgencias del Hospital General de Zona No. 1 en Aguascalientes.
Material y métodos: Se realizó un estudio analítico, retrospectivo y transversal
basado en la revisión de expedientes clínicos electrónicos. Se incluyeron 156
pacientes hospitalizados con diagnóstico de LRA durante el año 2023. Se
recolectaron variables sociodemográficas, comorbilidades, tratamientos utilizados
y valores de creatinina y urea. Los datos fueron analizados con estadística
descriptiva, pruebas de asociación bivariada e inferencia multivariada mediante
regresión logística, utilizando SPSS 27. Resultados: La edad media fue de 56.38
años, con distribución equitativa por sexo. El 43.6 % presentó LRA Grado 2 y el
39.7 % Grado 1. Las comorbilidades más frecuentes fueron hipertensión arterial
(48.1 %) y diabetes mellitus (42.9 %). La enfermedad cardiovascular (OR = 3.935;
p = 0.001), el uso de antibióticos (OR = 4.398; p < 0.001) y la creatinina de ingreso
(OR = 0.860; p = 0.014) se identificaron como predictores independientes del
desarrollo de LRA moderada o severa. El 30.1 % de los pacientes requirió
vasopresores y el 76.3 % recibió antibióticos durante su estancia en urgencias.
Conclusiones: Los hallazgos destacan la importancia de monitorear activamente
la función renal en pacientes con enfermedad cardiovascular o en tratamiento
antibiótico desde el ingreso a urgencias.
4
Palabras clave: Lesión renal aguda, factores de riesgo, urgencias hospitalarias.
ABSTRACT
Background: Acute kidney injury (AKI) is a common complication in hospitalized
patients, especially in emergency departments, and is associated with increased
morbidity and mortality and prolonged hospital stay. In critical clinical settings,
various factors such as cardiovascular comorbidities, severe infections, and the
use of nephrotoxic drugs have been linked to its onset and progression. However,
there is limited local evidence on its clinical behavior and associated factors in
Mexican patients. Objective: To identify risk factors associated with the
development and severity of acute kidney injury in adult patients hospitalized in the
emergency department of General Hospital of Zone No. 1 in Aguascalientes.
Material and methods: An analytical, retrospective, and cross-sectional study was
conducted based on the review of electronic medical records. One hundred and
fifty-six
patients hospitalized with AKI during 2023 were included.
Sociodemographic variables, comorbidities, treatments used, and creatinine and
urea levels were collected. Data were analyzed using descriptive statistics,
bivariate association tests, and multivariate inference using logistic regression,
using SPSS 27. Results: The mean age was 56.38 years, with equal distribution
by sex. Grade 2 AKI was present in 43.6% and Grade 1 in 39.7%. The most
frequent comorbidities were arterial hypertension (48.1%) and diabetes mellitus
(42.9%). Cardiovascular disease (OR = 3.935; p = 0.001), antibiotic use (OR =
4.398; p < 0.001), and admission creatinine (OR = 0.860; p = 0.014) were identified
as independent predictors of the development of moderate or severe AKI.
Vasopressors were required in 30.1% of patients, and antibiotics were
administered in 76.3% during their ED stay. Conclusions: The findings highlight
the importance of actively monitoring kidney function in patients with
cardiovascular disease or receiving antibiotic treatment from the moment they are
admitted to the emergency department. Keywords: Acute kidney injury, risk factors,
hospital emergency department.
Keywords: Acute kidney injury, risk factors, hospital emergencies.
