Abstract

Early identification and interventions are necessary in the scenario of critical patients with a high incidence of acute kidney injury (AKI), therefore an adequate dimensioning of the nursing team is among the necessary conditions to avoid work overload and enable quality care . The objective of this study was to verify the risk factors for AKI in critically ill patients and the impact on nursing workload. Methods: Prospective quantitative cohort study carried out in an Intensive Care Unit (ICU) with follow-up of 141 patients. Clinical and demographic characteristics were collected, in addition to the Simplifield Acute Physiology Score III (SAPS III), Sequential Sepsis-related Organ Failure Assessment (SOFA) and nursing workload was quantified by the Nursing Activities Score (NAS). Acute kidney injury was identified by Kidney Disease: Improving Global Outcomes (KDIGO). The Chi- square and Fisher's exact tests were used to verify associations between variables, considering p values <0.001 to be significant. Results: AKI was identified in 41.85% of patients. Those with AKI remained in the ICU longer (9.0 [5.3 - 14.0] days vs 5.0 [3.0 - 8.0] days, p<0.001), used more vasoactive drugs (73% vs 33%, p<0.001) and diuretics (36% vs 17%, p=0.012) and were more severe according to SOFA scores [3.30 (2.26 - 5.00) vs 0. 66

(0.06, 2.29, p<0.001] and SAPS 3 [55 (42 - 65) vs 0.66 (0.06 - 2.29, p<0.001] when compared

to patients without AKI. The burden of nursing work, quantified by the NAS, was higher in patients with AKI [RR 5.93 (95% CI 3.35 - 11.1), p<0.001). Conclusion: Critically ill patients with AKI using vasoactive drugs and diuretics have a more severe clinical condition expressed by the SAPS and SOFA and require a greater workload expressed by the higher Nursing Activities Score.