Pattern of acute kidney injury and its outcome in a tertiary care centre

Jennie Santhanam, Meenakshi Sundari Subramaniyan Natarajan, Annam Lakshmanan, Rajeswari K. Balakrishnan


Background: Acute kidney injury is a multiplex disease with severe morbidity and mortality. The trends of acute kidney injury vary according to the regions and the population under study. The aim of this study is to evaluate the trends of acute kidney injury and its outcome in a tertiary care hospital.

Methods: The study was a prospective observational study conducted at a tertiary care hospital in a metropolitan city. A total of 102 patients of acute kidney injury were selected based on the Kidney Disease Improving Global Outcomes guidelines of acute kidney injury. The main trends of acute kidney injury presentation and its outcome were assessed.

Results: Of 102 patients admitted, 42 had a sepsis related diagnosis (42.41%), 17 patients (17.16%) had cardiovascular disease related acute kidney injury and 12 patients (12.12%) had developed acute kidney injury due to drugs and poisons. According to RIFLE (risk of renal failure, injury to kidney, failure and loss of function and end-stage kidney disease) category, 43.96% of patients belonged to the risk category and 30.77% to the injury category. Of 34 patients in failure category, 23 recovered and 11 did not recover. Authors compared the trends of acute kidney injury in patients who recovered and who deteriorated. The mean serum creatinine values were 3.42 mg/dl in patients who didn’t recover from acute kidney injury and 2.05 mg/dl in patients who recovered. In patients of the recovered group, the mean urine output value is 783 ml/day; in deterioration group, 445 ml/day.

Conclusions: Most common etiologies of acute kidney injury in this study include sepsis, drugs and poisons, cardiovascular diseases and diarrheal diseases in order of occurrence. High serum creatinine at admission and oliguria were the most common factors that contributed to deterioration in acute kidney injury.


Acute kidney injury, Risk of renal failure injury to kidney failure and loss of function and end-stage kidney disease criteria, Sepsis, Serum creatinine

Full Text:



Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidn Intern Supplem. 2012 Jan 1;2(1):1-38.

Lopes JA, Jorge S. The RIFLE and AKIN classifications for acute kidney injury: a critical and comprehensive review. Clin Kidn J. 2013 Feb 1;6(1):8-14.

Lewington AJ, Cerdá J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidn Intern. 2013 Sep 1;84(3):457-67.

Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. The Lancet. 2013 Jul 13;382(9887):170-9.

Chawla LS, Amdur RL, Amodeo S, Kimmel PL, Palant CE. The severity of acute kidney injury predicts progression to chronic kidney disease. Kidney Int. 2011;79:1361‑9.

Ishani A, Nelson D, Clothier B, Schult T, Nugent S, Greer N, et al. The magnitude of acute serum creatinine increase after cardiac surgery and the risk of chronic kidney disease, progression of kidney disease, and death. Arch Intern Med. 2011;171:226‑33.

Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: A systematic review and meta‑analysis. Kidney Int 2012;81:442‑8.

Basile DP, Anderson MD, Sutton TA. Pathophysiology of Acute Kidney Injury. Compr Physiol. 2012 Apr; 2(2):1303-53.

Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT: Hospital-acquired renal insufficiency: A prospective study. Am J Med. 1983 Feb 1;74(2):243-8.

Liano F, Pascual J, Madrid Acute Renal Failure Study Group. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Kidney Intern. 1996 Sep 1;50(3):811-8.

Liano F, Junco E, Madero R, Pascual J, Verde E. The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. Kidney Intern-Supplements. 1998 May 1(66):16-24.

Shusterman N, Strom BL, Murray TG, Morrison G, West SL, Maislin G. Risk factors and outcome of hospital-acquired acute renal failure: Clinical epidemiologic study. Am J Med. 1987 Jul 1;83(1):65-71.

Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W, et al. Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol. 2007 Apr 1;18(4):1292-8.

Kaul A, Sharma RK, Tripathi R, Suresh KJ, Bhatt S, Prasad N, et al. Spectrum of community acquired acute kidney injury in India: A retrospective study. Saudi J Kidney Dis Transpl. 2012;23:61928.

Bhattacharya PK, Roy A, Jamil M, Barman B, Murti SV, Marak PR. Clinical profile and determinants of short-term outcome of acute kidney injury: A hospital-based prospective study from North-eastern India. J Laborat Physic. 2019 Jan;11(1):5.