Study of causes and prognosis of acute kidney injury (AKI) in tertiary care institute

Abstract

Background: Acute kidney injury (AKI) is a common clinical syndrome with a broad aetiological profile. It is associated with major morbidity and significant mortality. This study is to determine the various causes of AKI, in our hospital and to find out the incidence of AKI by using renal failure indices and to analyze outcome of AKI pertaining to the aetiology.Methods: Study is conducted on 100 AKI patients on haemodialysis admitted in various medical wards of the Mc Gann Hospital attached to Shimoga institute of medical sciences, Shimoga. From January 1st, 2017 to June 30th, 2017 detailed history was taken in all the patients and a through physical examination was done. Baseline and peak levels of serum Creatinine, urine output was documented. Data regarding laboratory investigations were collected to confirm the etiology of AKI.Results: There were 65 males and 35 females. The highest number of cases are in age group 51 to 60 year (32%). Average age is 56±5.6 years. Fever, nausea and oliguria are the most common clinical features seen 66,66 and 64 percentage respectively, followed by edema (23%) and loses tools (17%). Blood urea (>100), serum Creatinine (>4) in 44% and 46% respectively. Hb <10 gm/dl in 54%. WBC count >12000 in 65%. Sepsis and gastroenteritis are leading medical causes 25% and 12% respectively. Surgical causes are 14% and obstetrics causes are 11%.Conclusions: AKI remains a common disorder among critically ill patients Consistent with other studies from developing world; this study has also shown that infections, nephrotoxins and gastroenteritis are the primary causes of AKI at our institute. Most of these causes can be prevented with simple interventions such as health education on oral rehydration, quality prenatal and emergency obstetric care, appropriate management of infections and taking appropriate precautions when prescribing potentially nephrotoxic medications.