Abstract
Although acute kidney injury (AKI) in our setting is growing rapidly, the available data on the magnitude of this lethal problem are very limited. The objective of this study was to determine the incidence, epidemiology and outcome of AKI. A total of 143 hospitalized patients with AKI in Al Thawra General Hospital, nephrology department between July 2015 and December 2016 were enrolled. The mean age of the study population was 37.7 ± 8.4 years, and 68.5% of these patients were males. Almost 81.8% of cases were medically referred and malarial infection was the commonest cause of AKI (23%). Pre renal AKI was present in 65 patients (45.4%) and renal AKI in 78 patients (54.5%). Most cases were presented with clinical manifestation of volume overload (65%), oliguria (51.7%), anuria (16.7%), and high serum creatinine level. The majority of cases (58.7%) had recovered without dialysis. In-hospital mortality was observed in 11 patients (7.7%). Hepatic failure and malarial infection were the common causes of death. This study demonstrates low frequency of AKI in our setting. The etiologies of this lethal health problem are preventable and treatable in approximately half of cases. Late referral to hospital may contribute both to the progression of renal disease and also to high mortality.
Highlights
Acute renal failure (ARF) is a serious complication in hospitalized patients
It is responsible for approximately 2 million deaths annually worldwide [5] and the mortality rate reported among those patients with the most severe form of acute kidney injury (AKI) requiring renal replacement therapy as 50 – 80% [6]
Malaria was the most common cause of AKI accounted for 23%, followed by gastroenteritis 12.5% and chronic kidney disease 10.4%
Summary
Acute renal failure (ARF) is a serious complication in hospitalized patients. In the literature, there is more than 30 definitions of ARF leading to high variation in the reported incidence and outcome, for this reason the term acute kidney injury (AKI) has been recently used instead of ARF to provide a uniform definition and classification [1]. AKI results in a significant burden for the society in terms of health resource use during the acute phase and the potential long-term complications including development of chronic kidney disease (CKD) and kidney failure [3]. AKI is characterized by an abrupt decrease in the renal function that occurs within hours or days, resulting in fluid and electrolytes imbalance [4]. It is responsible for approximately 2 million deaths annually worldwide [5] and the mortality rate reported among those patients with the most severe form of AKI requiring renal replacement therapy as 50 – 80% [6]. Several risk factors including aging, sepsis, cardiovascular and pulmonary regurgitation are associated with increased risk of AKI development [4]
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