Frequency of etiologies of acute kidney injury in Faisalabad and surrounding districts
DOI:
https://doi.org/10.18203/2320-6012.ijrms20195551Keywords:
Background, To find out the causes of Acute Kidney Injury (AKI) in population. Methods, A total of 150 patients were enrolled from medical, surgical, gynecology and obstetrics units of Allied Hospital and Madinah Teaching Hospital, Faisalabad, Pakistan.Abstract
Background: To find out the causes of Acute Kidney Injury (AKI) in population.
Methods: A total of 150 patients were enrolled from medical, surgical, gynecology and obstetrics units of Allied Hospital and Madinah Teaching Hospital, Faisalabad, Pakistan. History, physical examination and investigations were recorded on specially designed proforma. Patients were evaluated to find out the etiologies of AKI. All patients were subjected to urine analysis, complete blood count, blood biochemistry (urea, creatinine, electrolytes, uric acid, calcium and phosphorus) and ultrasound scan of the abdomen and pelvis. Renal biopsy, immunological assays, such as hepatitis B surface antigen, anti-hepatitis C virus antibody, complements level, antinuclear antibody, anti-double-stranded DNA, anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody were performed in selected cases.
Results: Male (36%) and female (64%). Pre-renal AKI was most common and was reported in 80 patients (53.33%). Intrinsic Renal azotemia in 56 patients (37.33%). Post renal azotemia in 14 patients (9.33%). Among 80 patients of prerenal AKI, hemorrhage in 45(56.25%), gastroenteritis in 16(20%), sepsis in 8(10%), cardiac diseases in 4(5%), hepatorenal syndrome in 3 (3.75%), peritonitis in 2 (2.50%) and burns in 2(2.50%) were the main causes of Pre-renal AKI. Among 56 patients of intrinsic renal AKI, 40(71.4%) had acute tubular necrosis (ATN), 12(21.4%) with multifactorial causes and 4(7.14%) were found to have glomerulonephritis. Among 14 patients of post renal AKI, 6(42.9%) were having calculi, 6(42.9%) were to have enlarged prostate and 2(4.3%) were having stricture urethra. In this study, contribution of obstetrical, medical and surgical etiologies were recorded as 40%, 36% and 20% respectively.
Conclusions: In contrast to study reported from neighbouring country, this study shows rather increase in pregnancy related AKI.
References
Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney international. Supplement. 2009 Aug;(113):S1.
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 Apr;11(2):R31.
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure–definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004 Aug;8(4):R204.
Makris K, Spanou L. Acute kidney injury: definition, pathophysiology and clinical phenotypes. Clini Biochem Reviews. 2016 May;37(2):85.
Li PK, Burdmann EA, Mehta RL. World Kidney Day 2013: acute kidney injury: global health alert. Am J Kidney Dis. 2013;61(3):359-63.
Xue JL, Daniels F, Star RA, Kimmel PL, Eggers PW, Molitoris BA, et al. Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001. J Am Soc Nephrol. 2006 Apr 1;17(4):1135-42.
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.
Kohli HS, Bhat A, Jairam A, Aravindan AN, Sud K, Jha V, et al. Predictors of mortality in acute renal failure in a developing country: a prospective study. Ren fail. 2007;29(4):463-9.
Wonnacott A, Meran S, Amphlett B, Talabani B, Phillips A. Epidemiology and outcomes in community-acquired versus hospital-acquired AKI. Clini J Am Soc Nephrol. 2014;9(6):1007-14.
Case J, Khan S, Khalid R, Khan A. Epidemiology of acute kidney injury in the intensive care unit. Crit Care Res Pract. 2013;2013.
Cerdá J, Bagga A, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nat Rev Nephrol. 2008;4(3):138.
Obialo CI, Okonofua EC, Tayade AS, Riley LJ. Epidemiology of de novo acute renal failure in hospitalized African Americans: comparing community-acquired vs hospital-acquired disease. Arch intern med. 2000;160(9):1309-13.
Prakash J, Singh TB, Ghosh B, Malhotra V, Rathore SS, Vohra R, et al. Changing epidemiology of community-acquired acute kidney injury in developing countries: analysis of 2405 cases in 26 years from eastern India. Clini kind J. 2013;6(2):150-5.
Al Homrany M. Epidemiology of acute renal failure in hospitalized patients: experience from southern Saudi Arabia. East Mediterr Health J. 2003;9:1061-67.
Bramham K, Hall M, Piersy CN. Acute kidney injury Cambridge university press 2018. Available at: https://www.cambridge.org/core/books/renal-disease-in-pregnancy/acute-kidney-injury/BFE390 E3B6A936E3B0C10E80B897E9A287C.
Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: a prospective study. Am J Med. 1983;74(2):243-8.
Turney JH, Marshall DH, Brownjohn AM, Ellis CM, Parsons FM. The evolution of acute renal failure, 1956-1988. QJM: Intern J Med. 1990;74(1):83-104.
Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med. 1996;334(22):1448-60.
Kleinknecht D, Jungers P, Chanard J, Barbanel C, Ganeval D. Uremic and non-uremic complications in acute renal failure: Evaluation of early and frequent dialysis on prognosis. Kidney Intern. 1972;1(3):190-6.
Gameiro J, Fonseca JA, Neves M, Jorge S, Lopes JA. Acute kidney injury in major abdominal surgery: incidence, risk factors, pathogenesis and outcomes. Annals Intensive Care. 2018 Dec 1;8(1):22.
Jim B, Garovic VD. Acute Kidney Injury in pregnancy. Semin Nephrol. 2017;37(4):378-85.
Prakash J, Pant P, Prakash S, Sivasankar M, Vohra R, Doley PK, et al. Changing picture of acute kidney injury in pregnancy: Study of 259 cases over a period of 33 years. Ind J Nephrol. 2016;26(4):262.
Marady H, Huaifu X. Why People Prefer Seeking Care from One Country to Other Countries: A Case Study from Cambodia. MOJ Public Health. 2017;6(4):373-6.
Ansari MR, Laghari MS, Solangi KB. Acute renal failure in pregnancy: one year observational study at Liaquat University Hospital, Hyderabad. JPMA. J Pak Med Assoc. 2008;58(2):61.
Rabbani MA, Habib HB, Siddiqui BK, Tahir MH, Ahmad B, Murtaza G, et al. Etiology of acute renal failure in a tertiary center. Saudi J Kid Dis Transplant. 2008;19(6):1009.
Mehta RL, Cerdá J, Burdmann EA, Tonelli M, García-García G, Jha V, et al. International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case nephrology. Lancet. 2015;385(9987):2616-43.
Cooke WR, Hemmilä UK, Craik AL, Mandula CJ, Mvula P, Msusa A, Dreyer G, Evans R. Incidence, aetiology and outcomes of obstetric-related acute kidney injury in Malawi: a prospective observational study. BMC Nephrol. 2018;19(1):25.
Siribamrungwong M, Chinudomwong P. Relation between acute kidney injury and pregnancy-related factors. J Acu Dis. 2016;5(1):22-8.
Arrayhani M, El Youbi R, Sqalli T. Pregnancy-related acute kidney injury: experience of the nephrology unit at the university hospital of fez, Morocco. ISRN Nephrol. 2012;2013.
Mehrabadi A, Liu S, Bartholomew S, Hutcheon JA, Magee LA, Kramer MS, et al. Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study. BMJ. 2014;349:4731.
Yang L. Acute Kidney Injury in Asia. Kidney Dis (Basel). 2016;2(3):95-102.
