“Clinical Profile of Cases of Acute Kidney Injury in a Tertiary Care Centre”

Abstract

Acute Kidney Injury (AKI), earlier termed Acute Renal Failure, is a very common entity affecting patients suffering from a wide variety of illnesses. It refers to a clinical entity characterized by a rapid decrease in renal excretory function with increase in levels of urea and creatinine and decreased urine output. In the initial stages of aki these patients can be easily managed. However, AKI in the setting of multiple co-morbidities is very difficult to manage and is a potentially fatal complication. This study was conducted to analyse the incidence, types, etiological factors, management protocol and mortality secondary to AKI in a in tertiary care hospital. 172 patients admitted in the hospital were included in the study. Patients were selected if their serum creatinine level on the day of admission was more than 1.5 times of the baseline serum creatinine or the urine output was less than 0.5 ml/kg/h for 6 h or the GFR was less than 25 % from the baseline. Patients were classified as pre-renal, renal or post-renal AKI based on history, clinical findings and investigation results. Out of 172 patients with AKI, 35 patients had chronic kidney disease. Infection accounted for 48.8% of all cases followed by volume loss (17.4%) and drugs (12%). Other important causes were altered renal hemodynamics (6.3%), and obstructive uropathy (4%). Pre-renal cause accounted for 84 cases, Renal cause for 79 cases and Post-renal cause for 7 cases. Out of 172 patients, 83 belonged to the Risk category, 57 developed Kidney Injury and 32 developed kidney failure. A total of 52 (30.5%) patients required renal replacement therapy. Out of these 35 underwent hemodialysis, 12 underwent peritoneal dialysis and 5 required CVVHD.