Clinical spectrum of acute kidney injury: a study from tertiary care hospital

Abstract

Introduction: Acute Kidney injury (AKI) or Acute Renal Failure (ARF) is a common medical problem. Variety of conditions can lead to ARF. Many factors can influence the outcome of AKI. The aim of the present study was to analyze the clinical spectrum, causes, risk and prognostic factors and final outcome of AKI. Methods: This prospective study involved patients admitted to tertiary care hospital during March 2012 to February 2013. The clinical and laboratory data were collected at admission and then on daily basis. Patient characteristics, underlying medical conditions, dialysis, need for ventilation, total duration of hospital and ICU stay and final outcome, and these data were analyzed. Results: One hundred and twenty patients were admitted to our hospital fulfilled the criteria of acute kidney injury. Most of the patients 43.3% were in 31-50 years and 56.6% were males. Comorbidity was seen in 41(34.2%) patients were diabetes was most common 43.9%. ARF had developed complicating medical and surgical conditions in 74 (61.6%) and 35 (29.2%) patients respectively. The etiology of ARF was multifactorial and included; sepsis 51.3%, hypotension (33.7%), volume depletion (18.9%). Multiple organ dysfunctions noted in 55% of cases and dialysis was required in 51.6% patients. Mortality occurred in 28.3% of patients. MODS and sepsis were found to be significant adverse prognostic factors. Conclusions: AKI was seen in 4.2% of cases in our hospital admission. Presence of sepsis, MODS and ventilation need were correlated with higher mortality in AKI patients.