117 a Prospective Study of Acute Kidney Injury in Tropical Acute Febrile Illness in West Pahang, Malaysia

Abstract

medical records in the hospital information system. Results were analyzed using SPSS version 23. Results: A total of 78 patients fulfilled the inclusion criteria. The mean age was 52.4 and predominantly male (66.6%). Comorbidities identified in this cohort were diabetes mellitus, hypertension and ischemic heart disease bringing to a total of 52.5%, followed by patients with preexisting CKD stage 2 to 4 (23%), retroviral disease (RVD) (7.7%) and there were 2 patients with underlying malignancy. 13 patients (16.7%) had no known medical illness. Main causes of AKI requiring HD in the group with comorbidities were sepsis (56.4%), cardiogenic shock(12.7%), obstructive uropathy(7.7%), trauma related(6.4%), ingestion of traditional medicine and nephrotoxic drugs(6.4%), hypertensive emergency(6.3%), burn related disease(2.5%) and radiocontrast agents(1.6%). Amongst the cohort with no medical illness, non-sepsis cause (medication and trauma related) predominated (76.4%). 17.9% of the study group developed hospital acquired AKI requiring HD. Within 90 days, 39.7% died during hospitalization. Amongst those alive at 90 days, 51.3% achieved full renal recovery, 29.7% were rendered end stage renal disease requiring regular dialysis and 19% were diagnosed with new onset chronic kidney disease or developed progression of their chronic kidney disease but did not require regular dialysis. Conclusion: AKI requiring HD should be identified as a predictor of inpatient mortality and long term morbidity. It is imperative that early recognition and intervention is undertaken to reduce the burden of disease.

Clinical Characteristics of Acute Kidney Injury Associated with Tropical Acute Febrile Illness

“…Three studies of TAFI-associated AKI conducted in India between 2010 and 2018 reported a prevalence between 28–54% using either RIFLE or KDIGO criteria [ 4 , 30 , 31 ]. One study from Malaysia in 2017 reported TAFI-associated AKI with a prevalence of 41.1%, using KDIGO [ 32 ]. The wide range of reported AKI prevalence was due to the different AKI criteria being used, as well as the different etiology of AKI in these places.…”