Frequency of Risk Factors and Outcome of Hospital-Acquired Acute Kidney Injury.

Hina Iram,Shafique A Solangi,Ayesha Ejaz,Muhammad Ali,Noor Un Nisa,Sagheer Ahmed Solangi,Abdul Manan Junejo,Vinod Kumar

doi:10.7759/cureus.12001

Abstract

Objective: To determine the frequencies of risk factors and the ultimate outcomes of ccute kidney injury (AKI) among hospitalized patients.Materials and methodology: This prospective, observational study was carried out from September 15, 2018, to March 14, 2019. All admitted patients, both male and female, with AKI, were included. Those with chronic kidney disease (CKD), small size echogenic kidneys (on ultrasonography, performed on admission), and recent history of urological intervention were excluded from the study. All patients were assessed for etiological factors (sepsis, gastroenteritis, surgical, and obstetrical) and outcome (improved, progression to CKD, or expired).Results: Out of a total of 230, most patients were aged between 20-50 years with a mean age of 38.99 ± 7.61 years. Males were 144 (62.61%) and females were 86 (37.39%). About 78 (33.91%) patients were hypertensive while 65 (28.26%) were diabetic. The cause of hospital-acquired AKI was found to be sepsis in most (71.73%, n=165) of the cases, followed by gastroenteritis (10.00%, n=23), surgical (9.56%, n=22), and obstetric (8.69%, n=20) causes. When the outcome was assessed, 10 (4.35%) patients expired, 154 (66.96%) improved completely, while 66 (28.69%) progressed to CKD.Conclusion: This study has shown that sepsis is the most common cause of AKI in patients admitted to the hospital. So we recommend that proper steps should be taken to ensure adequate hospital care for avoiding such outcomes in hospitalized patients, and further decrease mortality.

Highlights

Acute kidney injury (AKI), recently taking over the previous term acute-renal failure (ARF), is a sudden decline in renal function and represents both structural and functional damage
All patients were assessed for etiological factors and outcome
This study has shown that sepsis is the most common cause of AKI in patients admitted to the hospital

Summary

Introduction

Acute kidney injury (AKI), recently taking over the previous term acute-renal failure (ARF), is a sudden decline in renal function and represents both structural and functional damage. It is a fairly common condition affecting public health globally. The Acute Dialysis Quality Initiative (ADQI) defined ARF and established a staging criterion called the RIFLE criterion (Risk, Injury, Failure, Loss, and End-stage kidney disease) in 2002. The AKI network came into existence in 2004 and introduced the term ‘Acute Kidney Injury’, reflecting the entire array of ARF. According to the proposed diagnostic criteria for AKI (Kidney Disease Improving Global Outcomes - KDIGO), when there is a sudden decline (within 48 hours) in kidney function (serum creatinine >0.3 mg/dL), or >50% increase in serum creatinine, or decreased urine output of six hours, it is diagnosed as AKI [1,2,3,4]

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