Epidemiology and outcome of acute kidney injury from a tertiary care hospital in India

Abstract EN

We aimed to study the epidemiology and outcome of acute kidney injury (AKI).

This is a prospective study of adults aged 18 years or above diagnosed with AKI over a period of 16 months at a tertiary care hospital.

Three hundred and nine patients had AKI.

The observed incidence of AKI was eight per 1000 admissions.

About 92.2% had community-acquired AKI (CA-AKI), and in 7.8% it was hospital-acquired AKI (HA-AKI).

Etiological factors for AKI were medical in 87.4% of the cases, surgical in 9.4%, and obstetric 3.2%.

Sepsis was the most common (53.1%) etiology of AKI among the medical cases.

Among sepsis, scrub typhus, urosepsis, and pneumonia were the most common causes of AKI.

Hypovolemia (9.4%), biological toxins (8.4%), nephrotoxic drugs and chemicals (7.4%), cardiac causes (7.4%), and acute glomerulonephritis (1.9%) were other medical causes of AKI.

Nearly 38.2% had multiorgan failure, 20.1% required vasopressors, 6.1 % required Intensive Care Unit support, and 23.3% required dialysis.

Mortality was 8.7%.

Anemia, use of vasopressor drugs, and need for intensive care support were independent predictive factors for mortality.

AKI is common in hospitalized adults in India and leads to significant in-hospital mortality.

AKI is largely a CA-AKI and the lesser percentage is due to HA-AKI.

Many causes are potentially preventable.

Early fluid resuscitation, effective antiinfective treatment, appropriate antidotes, and timely referral of established AKI patients to centers with dialysis facilities can improve AKI outcomes.