A cross-sectional study of etiology, clinical profile, prognosis and outcome of acute kidney injury in a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263096Keywords:
Acute kidney injury, AKIN criteria, Etiology, Prognosis, Hemodialysis, Outcome, SepsisAbstract
Background: Acute kidney injury (AKI) is a common and serious clinical condition associated with significant morbidity, mortality, prolonged hospital stay, and increased healthcare burden. Early identification of etiological factors and severity is essential for timely intervention and improved outcomes.
Methods: A hospital-based analytical cross-sectional study was conducted among 150 patients with AKI admitted to a tertiary care hospital over 18 months. Patients fulfilling acute kidney injury network (AKIN) diagnostic criteria were included. Demographic characteristics, clinical profile, urine output, etiological factors, AKI type, AKIN stage, treatment modalities, and outcomes were recorded. Relevant laboratory investigations and imaging studies were performed, and data were analyzed using descriptive statistics.
Results: The mean age of participants was 43.96 years, with a male predominance. Oliguria was the most common clinical presentation. Sepsis was the leading etiological factor, followed by poisoning and snake bite. Intrinsic renal AKI was the predominant type, while post-renal AKI was uncommon. Most patients presented with AKIN stage 3 disease. Conservative management was sufficient for many patients, whereas others required hemodialysis. Recovery was observed in the majority of patients, although mortality remained higher among those with severe AKI and associated systemic illness.
Conclusions: Sepsis, poisoning, and snake bite were the major contributors to AKI in the study population. Early diagnosis, prompt identification of the underlying etiology, timely treatment, and appropriate renal replacement therapy are essential for improving clinical outcomes and reducing AKI-related mortality.
References
Kellum JA, Lameire N. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary. Crit Care. 2013;17(1):204.
Hoste EAJ, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol. 2018;14(10):607-25.
Bhattacharya PK, Ahmed K, Roy A, Rahman MM. Clinical profile and short-term outcome of acute kidney injury in a tertiary care hospital. J Assoc Physicians India. 2019;67(5):42-6.
Pursnani L, Kumar S, Sharma D, Singh R. Clinical profile and predictors of mortality in community acquired acute kidney injury patients. Saudi J Kidney Dis Transpl. 2014;25(6):1295-301.
Hsu RK, Hsu CY. The role of acute kidney injury in chronic kidney disease. Semin Nephrol. 2016;36(4):283-92.
Mahesh E, Puri S, Varma V, Madhyastha PR, Mohan KJ, Singh SK. Etiology and outcomes of acute kidney injury in a tertiary care hospital. Indian J Nephrol. 2017;27(2):111-7.
Vikrant S, Gupta D, Singh M. Epidemiology and outcome of acute kidney injury in hospitalized patients. Saudi J Kidney Dis Transpl. 2018;29(4):956-63.
Wonnacott A, Meran S, Amphlett B, Talabani B, Phillips A. Epidemiology and outcomes of community-acquired versus hospital-acquired acute kidney injury. Clin Kidney J. 2014;7(4):332-9.
Peerapornratana S, Manrique-Caballero CL, Gómez H, Kellum JA. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int. 2019;96(5):1083-99.
Mehta RL, Cerda J, Burdmann EA, Tonelli M, Garcia-Garcia G, Jha V, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury. Lancet. 2015;385(9987):2616-43.
Chugh KS. Snake-bite-induced acute renal failure in India. Kidney Int. 1989;35(3):891-907.
Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. Lancet. 2013;382(9887):170-9.
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(2):R31.
Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Long-term risk of mortality and other adverse outcomes after acute kidney injury. Am J Kidney Dis. 2009;53(6):961-73.
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84.
Evans RDR, Hemmilä U, Craik A, Mtekateka M, Hamilton F, Kawale Z, et al. Incidence, etiology and outcome of community-acquired acute kidney injury in medical admissions in Malawi. BMC Nephrol. 2017;18(1):21.
Hsu CN, Lee CT, Su CH, Wang YC, Chen HL, Chuang JH, et al. Incidence, outcomes, and risk factors of community-acquired and hospital-acquired acute kidney injury: a retrospective cohort study. Medicine (Baltimore). 2016;95(19):e3674.
Patel N, Sharma A, Verma S, Gupta R. Comparative study of community-acquired and hospital-acquired acute kidney injury in a tertiary care center in North India. Indian J Nephrol. 2024;34(2):145-52.
Downloads
Published
How to Cite
Issue
Section
