Outcome of sepsis-associated acute kidney injury in an intensive care unit : an experience from a tertiary care center of central Nepal

الملخص EN

Acute kidney injury (AKI) is a common and major complication of sepsis.

Sepsisinduced AKI is associated with higher morbidity and mortality.

A prospective study was designed to include all the patients with a provisional diagnosis of sepsis with AKI admitted in our intensive care unit from August 2009 to September 2010.

Detailed demographic data including various clinical parameters, co-morbidities, investigations, complications and outcome were entered in a designated proforma and were analyzed.

A total of 53 subjects with the provisional diagnosis of sepsis with AKI were included in the study.

The majority of patients (60.37 %) were female.

The mean age of the study population was 45.84 ± 20.5 years.

Forty-nine percent of the subjects were < 45 years old and 26.4 % patients were > 65 years.

Among the co-morbid conditions, 9.4 % subjects had diabetes mellitus type 2.

Among the primary causes of AKI, 72 % of the cases were due to medical causes, in which pneumonia was the major cause, and 28 % were due to surgical causes, in which cholecystitis was the major cause.

47.1 % cases expired, 11.3 % subjects left against medical advice and 41.5 % cases had favorable outcome.

Among the expired cases, 20.7 % subjects expired within 24 h ; for others, the median hospital stay was four days.

This prospective study showed that the major causes of AKI were medical illness and pneumonia.

Mortality in sepsis-induced AKI is significantly high.

This highlights the importance of prevention of AKI in sepsis by early and renal-friendly aggressive treatment of sepsis and the need for improvement in the management of such AKI cases.