Understanding the clinical spectrum and etiological factors of acute kidney injury in patients at a tertiary care hospital, SSG Hospital, Vadodara: an observational study

Divyang Bhudhrani; Yashvi P. Patel; Jinesh J. Patel; Kush P. Patel; Rudra S.  Patel

doi:10.18203/2320-6012.ijrms20250692

Authors

Divyang Bhudhrani Department of Internal Medicine, Bukovinian State Medical University, Chernivtsi Oblast, Ukraine
Yashvi P. Patel Department of Internal Medicine, GCS Medical College, Gujarat, India
Jinesh J. Patel Department of Internal Medicine, GMERS Medical College and Hospital Gandhinagar, Gujarat, India
Kush P. Patel Department of Internal Medicine, Medical College Baroda, Gujarat, India
Rudra S. Patel Department of Internal Medicine, Medical College Baroda, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250692

Keywords:

Acute kidney injury, Clinical spectrum, Etiological factors, Observational study, Tertiary care hospital

Abstract

Background: Acute kidney injury (AKI) represents a significant burden on healthcare systems globally due to its high morbidity and mortality rates. Early identification and management are crucial to mitigate adverse outcomes and enhance patient prognosis. This study aimed to investigate the clinical spectrum and etiological factors contributing to AKI among patients at SSG Hospital, Vadodara.

Methods: This observational study aimed to characterize the clinical presentation of AKI patients and explore the diverse etiologies contributing to AKI in a tertiary care setting. The study assessed demographic profiles, clinical symptoms, and prevalent etiological factors associated with AKI. Conducted from October 1^st, 2023, to March 31^st, 2024, it included 246 patients aged over 18 years admitted to the medicine ward and intensive care unit, excluding those with diabetic nephropathy or chronic kidney disease. Data collection involved detailed histories, clinical examinations, and application of KDIGO criteria for AKI diagnosis. Statistical analysis was performed using SPSS 11.5 software.

Results: Among the 246 patients, 162 were male and 84 females, with a mean age of 50.6±18.00 years. Common symptoms included decreased urine output (60%), swelling (56%), and vomiting (34%). Principal etiologies were acute gastroenteritis (20%), snake bites (18.8%), infective causes (15.8%), and poisoning/drug-induced (15.2%). Significant associations were found between clinical features and etiological factors.

Conclusions: This study offers insights into the clinical spectrum and diverse etiological factors contributing to AKI at SSG Hospital, Vadodara. Findings emphasize the need for early recognition and tailored management strategies based on prevalent regional etiologies. Further research is needed to validate these results and refine therapeutic approaches.

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References

Kellum JA, Lameire N, KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013;17(1):204. DOI: https://doi.org/10.1186/cc11454

Chawla LS, Eggers PW, Star RA, Kimmel PL. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med. 2014;371(1):58-66. DOI: https://doi.org/10.1056/NEJMra1214243

Bonventre JV, Yang L. Cellular pathophysiology of ischemic acute kidney injury. J Clin Invest. 2011;121(11):4210-21. DOI: https://doi.org/10.1172/JCI45161

Prowle JR, Bellomo R. Sepsis-associated acute kidney injury: macrohemodynamic and microhemodynamic alterations in the renal circulation. Semin Nephrol. 2015;35(1):64-74. DOI: https://doi.org/10.1016/j.semnephrol.2015.01.007

Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380(9843):756-66. DOI: https://doi.org/10.1016/S0140-6736(11)61454-2

Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med. 2006;34(7):1913-7. DOI: https://doi.org/10.1097/01.CCM.0000224227.70642.4F

Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care. 2006;10:1-10. DOI: https://doi.org/10.1186/cc4915

Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:1-8. DOI: https://doi.org/10.1186/cc5713

Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120179-84. DOI: https://doi.org/10.1159/000339789

KDIGO Board Members. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2(1):3. DOI: https://doi.org/10.1038/kisup.2012.3

Bagshaw SM, Bellomo R. Early diagnosis and prevention of acute kidney injury. Curr Opin Crit Care. 2007;13(6):638-44. DOI: https://doi.org/10.1097/MCC.0b013e3282f07570

Bagshaw SM, George C, Bellomo R. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients. Nephrol Dialys Transplant. 2008;23(5):1569-74. DOI: https://doi.org/10.1093/ndt/gfn009

Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet. 2005;365(9457):417-30. DOI: https://doi.org/10.1016/S0140-6736(05)17831-3