CLINICAL PROFILE OF ACUTE KIDNEY INJURY IN ICU PATIENT IN TERTIARY CARE HOSPITAL AND MEDICAL COLLEGE DAHOD, A TRIBAL AREA OF GUJARAT

Abstract

Acute kidney injury (AKI) is an outcome of multiple etiologies and is mostly reversible. Data on its incidence and outcome,particularly from India,are limited.Our aim was to study the etiology,clinical profile,and short-term prognosis in AKI.It was a hospital-based prospective observational study on AKI. Seventy-five AKI patients diagnosed by Acute Kidney Injury network criteria were selected. Patients with preexisting chronic kidney disease were excluded.Data were compiled using the Statistical Package for the Social Sciences version 17. Regression analysis was done for determining the association of various variables for mortality.P < 0.05 was considered statistically significant.The mean age of patients was 41.09 ± 16.17 years with a male:female ratio of 1.42:1. Comorbidities were present in 37.3%, with diabete smellitus (10.6%) and chronic liver disease (10.6%) being the most common.Fever was the most common (40%) presenting symptom, followed by oliguria (25.8%). Infection was the most common cause of AKI (56%), with sepsis in 26.7% followed by acute gastroenteritis in 17.3%. Pneumonia was the primary focus in 50% of cases with sepsis. Mean serum creatinine and urea at admission were 2.37 ± 0.90 and 92.44 ± 39.67 mg/dl, respectively. Serum creatinine rose progressively to 2.96 ± 1.18 and 3.26 ± 1.56 mg/dl at 24 and 48 h,respectively,since hospitalization.Majority of the cases (73.3%) were nonoliguric. Hemodialysis was necessary in 24% of cases. Mean hospital stay was 8.16 days. In-hospital mortality was 24%.Among survivors, 92.9% had complete renal recovery on discharge. Sepsis,need for hemodialysis, urea >100 mg/dl,and peak serum creatinine >3 mg/dl were contributors to mortality (P < 0.01).