A Study on Clinical Profile of Acute Kidney Injury (original) (raw)
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Acute Kidney Injury: Its Etiological Factors, Co-Morbidities and Mortality Risk
2020
AKI (Acute Kidney Injury) constitutes approximately 5-7% of hospital admissions and up to 30% of admissions to intensive care units. Large referrals to dialysis units suggest that the condition is more common in Pakistan. The study was conducted to identify the etiological factors, co-morbidities and mortality risk in AKI.
STUDY OF ACUTE KIDNEY INJURY IN PATIENTS ADMITTED IN INTENSIVE CARE UNIT IN TERTIARY CARE HOSPITAL
public health problem worldwide affecting millions of patients leading to decreased survival. AKI complicates 5–7% of acute care hospital admissions and up to 30% of admissions to the intensive care unit. AKI is a common complication of ICU and also associated with a markedly increased risk of death in hospitalized individuals, particularly in those admitted to the ICU where in-hospital mortality rates may exceed 50% when Compared to western literature, reports from our country are limited and hence there is a need to understand the clinical profile of these patients here. A thorough understanding of clinical spectrum of disease is needed in order to devise methods to improve final outcome due to AKI in ICU admitted cases. The present study aims to know the clinical spectrum of AKI in patients admitted in intensive care unit and to determine the risk, prognostic factors and final outcome of AKI patients who are admitted in intensive care unit tertiary care hospitals in Bangalore city. A total 100 patients of AKI patients admitted in ICU were considered for the study. The data was collected through a pretested proforma, which included various like patients history, Clinical examination, Diagnosis, Laboratory parameters, Urine output, Comorbid conditions, dialysis, MSOF etc., The Patients were followed up till the event of discharge or death in hospital. The main outcome evaluated was mortality. As per the analysis present study demonstrates majority of patients were in 51 to 60 years age group (24%) with highest mortality in 51 to 60 age group (32.1%). Fever was the most common presentation of patients (46%); Sepsis was the most common diagnosis (59%). Oliguric renal failure was seen in 49% cases. Comorbidity was seen in 51% of the patients; hypertension (30 cases), diabetes mellitus (23 cases), COPD (11 cases) and IHD (7 cases). A high overall mortality of 56% was seen which is consistent with other studies done in various parts of the world. Intrinsic type of renal failure was the most common type (68%). MSOF was noted in 63% of the patients. 37% of the patients required ventilator support and 45 % patients required dialysis. Mortality increased in older age group, comorbid conditions, oliguric renal failure. Sepsis was the most common cause. Intrinsic type of renal failure was the most common type of AKI seen. There was an increased mortality seen in patients who required dialysis, and mechanical ventilation. Presence of MSOF was associated with poor prognosis.
2022
Background: In this study, we aimed to evaluate the etiology, comorbidities and outcome of acute kidney injury (AKI) in our country, and if there is, to demonstrate any potential differences in different geographical parts of the country. Methods: This prospective observational study was carried on by Acute Kidney Injury Working Group of Turkish Society of Nephrology. Demographical and clinical data of AKI patients at the time of diagnosis, at the 1st week and 1st, 3rd and 6th months were evaluated to determine patient and renal survival, and factors associated with prognosis. Results: 776 patients were included (54.7% male, median age: 67 years). Prerenal causes were more frequent, namely dehydration, heart failure and sepsis. 58.9% of patients had at least one renal etiology, most frequently nephrotoxic agent exposure. Etiologic factors were mostly similar through the country. 33.6% of patients needed renal replacement therapy. At the 6th month of diagnosis, 29.5% of patients had ...
International Journal of Research and Review
INTRODUCTION: Acute Kidney Injury (AKI) is a common and serious problem in clinical medicine characterized by an abrupt decrease in renal function resulting in accumulation of nitrogenous waste products and inability to regulate fluid, electrolyte and acid-base balance in the body. OBJECTIVES: This study aims to evaluate the incidence of AKI development in hospitalized patients according to RIFLE criteria and assesses the co-relation between risk factors and the stages of AKI development. METHOD: A prospective cross sectional observational study was conducted among Acute Kidney Injury patients for a period of about 6 months. RIFLE Criteria was used to assess the patients. Data was analysed using SPSS v.20. Pearson’s chi square tests; correlations and linear regression analysis were used to analyse the data collected. RESULT: A total of 207 patients participated in this study. Majority were females with an age group of 50 and above. The incidence of Acute Kidney Injury according to R...
Pakistan Armed Forces Medical Journal
Objective: To assess the aetiology and outcome of patients admitted with acute kidney injury at the Nephrology Unit of Pak Emirates Military Hospital (PEMH). Study Design: Cross-sectional analytical study. Place and Duration of Study: Nephrology Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2019 to Jun 2020. Methodology: Patients admitted with AKI were included in the study. The Kidney Disease: Improving Global Outcomes(KDIGO) clinical practice guidelines were used to diagnose acute renal injury based on creatinine level or urine output. Results: A total of 300 patients were admitted to the Nephrology Unit with AKI during the study period. Sepsis was the commonest aetiology for acute kidney injury among the target population, followed by injury. 155(51.4%) patients were discharged, 53(17.7%) were stable in the ward, 70(23.4%) patients were shifted to the Critical Care Unit, and 22(7.3%) died.Long duration of hospital stay and the presence of multiorgan failure ...
"Etiology of Acute Kidney Injury in a Tertiary Care Hospital"
IOSR Journals , 2019
Acute kidney injury is one of the significant causes of morbidity and mortality world wide. The present study was done in a tertiary care hospital in East Godavari District , Andhra Pradesh, India, among 100 patients of acute kidney injury with an objective to find out the most common causes of AKI in this particular area. Results showed that the major causes of AKI in this area are sepsis, gastroenteritis, heart failure and malaria.
2022
Objectives: Acute Kidney Injury (AKI) is a very common clinical problem. This picture is seen in 5-7% of hospitalized patients and in 25-30% of patients hospitalized in intensive care units. The aim of this study was to determine the incidence, etiology, clinical features, prognosis and complications in adult patients hospitalized with of AKI. Methods: This study was organized as an observation study in which the files of the patients admitted to internal medicine and nephrology clinics between September 2012 and September 2017 were examined. All patients admitted to the internal medicine and nephrology clinics with the diagnosis of AKI were included in the study. But those under the age of 18, patients with chronic kidney damage, ex-patients after hospitalization, patients who were sent to the intensive care unit after hospitalization, patients who voluntarily refused treatment or left the service and who were hospitalized for more than 48 hours, but those who did not have biochemical analysis during their stay were excluded. RIFLE creatinine criteria were used for AKI identification. Results: The study included 354 patients. 177 (50%) patients were male and 177 (50%) patients were female. The incidence of prerenal AKI in the internal medicine and nephrology clinics was 53.39%, renal AKI was 36.44% and postrenal AKI was 10.17%. When the causes of AKI were examined, 33.9% hypovolemia, 15.5% UTI and 13.5% gastroenteritis were detected. The dialysis rate was 23.7%. Conclusion: Inconclusion, although the incidence of AKI is acceptable in our hospital. It is found to be compatible with the literature and it is possible to catch the early stage of injury by decreasing the frequency especially with better management of elderly patients and more closely monitoring renal functions in this group of patients
Clinical Profile of Patients Admitted with Acute Kidney Injury in Intensive Care Unit
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Acute Kidney Injury (AKI) in intensive care unit (ICU) is very common. This study looked at the clinical profile of patients admitted in ICU with AKI. MATERIALS AND METHODS Prospective observational study was done in an ICU of a tertiary care centre in Mangalore. Patients admitted to the ICU who were 18 years of age and had diagnosis of AKI by KDIGO criteria were included in the study. Data was collected and analysed. RESULTS Total number of patients included in the study was 100. Diabetes mellitus was the most common comorbidity seen in 38% cases followed by Hypertension in 27%. The duration of ICU stay ranged from 4 days to 12 days. Sepsis was the most common cause of AKI (51%). Forty-five percent of patients required haemodialysis. CONCLUSION Sepsis was the most common aetiological factor responsible for AKI. Diabetes mellitus was found to be the most common co-morbid illness associated with development of acute kidney injury. Respiratory tract infection was found to be the most common diagnosis at admission among those with AKI. Most AKI in ICU have oliguria. Acute tubular necrosis was found to be the most common pathophysiological process responsible for AKI. Forty-five percent of ICU-AKI patients require RRT. SOFA score of ≥ 9 and increasing severity of AKI were associated with increased mortality and also poor rate of recovery from acute kidney injury and increase d mortality.
The Professional Medical Journal
Objectives: To determine the frequency of acute kidney injury in hospitalizedpatients at Nishtar hospital, Multan. Study Design: Cross sectional study. Setting: MedicalUnit-IV, Nishtar Hospital, Multan. Duration: Duration of study was 6 months from 17/07/2015to 16/01/2016. Material and Methods: This study involved 383 patients of either sex agedbetween 37-60 years admitted to medical ward for various medical conditions. Results: Themean age of the patients was 48.96±7.24 years. There were 198 (51.7%) male and 185 (48.3%)female patients in the study group. The most frequent underlying cause requiring hospitaladmission was a respiratory tract disease observed in 153 (39.9%) patients. AKI was observedin 104 (27.2%) patients. When stratified the frequency of AKI increased significantly withincreasing age of the patient; 37-42 years vs. 43-48 years vs. 49-54 years vs. 55-60 years (17.3%vs. 22.7% vs. 26.2% vs. 42.0%; p=.001). It was also significantly (p=.000) higher in patientswith diabe...
Background : The burden of Acute Kidney injury in developing countries especially in Sub-Saharan Africa is enormous. The morbidity and mortality appears to be rising despite the availability of dialysis therapy in some parts of Africa. Objective: To determine the causes and the factors that influence outcome of acute kidney injury in hospitalized patients at the Design : This was a prospective study of patients with acute kidney injury admitted in UCTH, Calabar over a 12 month period from January 2014 to December 2014. Data was analysed using SPSS version 18. Results : A total of 1138 patients were admitted with 42 of them developing AKI giving an incidence rate of 3.6%. Eighteen (42.9%) of the participants were males while 24 (57.1%) were females. Age ranged from 11 to 81 years with a mean age of 44.2±17.32 years. The common causes of AKI were septicaemia 20 (47.6%), malignant phase hypertension 7 (16.7%) and hypovolaemia 4 (9.5%).Other causes accounted for the remaining 11 (26.1%). Thirty one (73.8%) had co-morbidities and hypertension 12 (38.7%) was the commonest co-morbid condition. For outcome, 29 (69.0%) of the patients were discharged home while 13 (31.0%) of them died in the hospital. Survivors had more dialysis sessions than those that died (P < 0.05). Conclusion : Septicaemia is the commonest cause of AKI in our centre. In-hospital mortality rate is high. The severity of AKI at presentation and lack of dialysis therapy are contributory factors.