Acute Renal Failure in Diabetes Mellitus (Prospective Study)

Abstract

Objective: To study the pattern and outcome of acute renal failure (ARF) in diabetes mellitus. Methods: Outcome of variables like duration of renal failure, recovery of renal function and mortality were analyzed with parameters like age, sex, duration of diabetes mellitus, preexisting diabetic nephropathy, preexisting ischemic heart disease, cause of renal failure, dialysis requirement and number of organ systems involved. Results: 70 patients with diabetes mellitus and acute renal failure were studied. Most common causes of acute renal failure were found to be sepsis and urinary tract obstruction. Most common cause of urinary tract obstruction was papillary necrosis. NSAID was most common cause of drug induced renal failure. Out of total 17 patients who underwent renal biopsy, 9 received steroid treatments had AIN, 1 had diffuse proliferative glomerulonephritis (DPGN). Out of 9 patients who had received steroid treatment, 6 patients had recovery of renal failure. Recovery of acute renal failure was found in 64.3% of the study group. Patients with urinary tract obstruction seemed to have better outcome of ARF recovery, when compared with other causes of acute renal failure, though it did not reach statistical significance. Duration of renal failure >10 days seemed to have poor outcome of ARF recovery, though it did not reach statistical significance. Surprisingly patients with sepsis appeared to have better outcome of ARF recovery, compared to other causes of renal failure with statistical significance. Conclusions: Most common causes of renal failure in our study were found to be sepsis and urinary tract obstruction. Acute renal failure recovered in 64.3%. Patients with urinary tract obstruction and sepsis seemed to have favorable outcome in ARF recovery.