Geographic and Clinical Patterns of Acute Kidney Injury Among Intensive Care Unit Patients in Turkey: A Subgroup Analysis of a National Prospective Cohort

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Background Acute kidney injury (AKI) is common among intensive care unit (ICU) patients and is associated with high morbidity and mortality. Data describing regional patterns of ICU‐associated AKI within a single country remain limited. This study aimed to provide a descriptive overview of regional variation in etiology, management, and outcomes of ICU patients with AKI in Turkey. Methods This secondary analysis of a national, prospective, observational cohort included adult ICU patients with AKI. Demographic characteristics, etiological factors, AKI severity, kidney replacement therapy (KRT) practices, and 6‐month outcomes were evaluated across geographic regions using descriptive and exploratory approaches. Formal statistical comparisons across regions were not performed due to small subgroup sizes. Results A total of 126 patients were included; 57.9% were male, with a median age of 69 years (IQR: 61.5–79). Prerenal factors were present in 80% of patients, frequently in combination with intrinsic causes such as sepsis and heart failure. More than half of patients (54.8%) had Stage 3 AKI. Overall outcomes were notably poor: cumulative survival rates were 46.4%, 27.1%, and 16.3% at 1, 3, and 6 months, respectively, a key finding of this study. Higher AKI stage, presence of sepsis, and greater inflammatory burden (based on SIRS criteria) were associated with poor outcomes in exploratory analyses. Variations in KRT modality were observed across regions, including greater use of continuous therapies in some centers. Due to limited sample size and small regional subgroups, comparisons across regions were not reliable. Conclusion ICU‐associated AKI in Turkey is characterized by high disease severity and poor outcomes, consistent with findings reported worldwide. Observed differences in management practices across centers should be interpreted cautiously. Given the limited sample size and exploratory design, this study does not allow reliable assessment of geographic differences and should be considered hypothesis‐generating. Larger adequately powered studies are needed to better define regional variability and improve patient outcomes.

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