DOI: http://dx.doi.org/10.18203/2349-3933.ijam20173252

Study of causes and prognosis of acute kidney injury (AKI) in tertiary care institute

Nagabhushana S., Ranganatha M., Ranjith Kumar G. K., Kamath Virupakshappa

Abstract


Background: Acute kidney injury (AKI) is a common clinical syndrome with a broad aetiological profile. It is associated with major morbidity and significant mortality. This study is to determine the various causes of AKI, in our hospital and to find out the incidence of AKI by using renal failure indices and to analyze outcome of AKI pertaining to the aetiology.

Methods: Study is conducted on 100 AKI patients on haemodialysis admitted in various medical wards of the Mc Gann Hospital attached to Shimoga institute of medical sciences, Shimoga. From January 1st, 2017 to June 30th, 2017 detailed history was taken in all the patients and a through physical examination was done. Baseline and peak levels of serum Creatinine, urine output was documented. Data regarding laboratory investigations were collected to confirm the etiology of AKI.

Results: There were 65 males and 35 females. The highest number of cases are in age group 51 to 60 year (32%). Average age is 56±5.6 years. Fever, nausea and oliguria are the most common clinical features seen 66,66 and 64 percentage respectively, followed by edema (23%) and loses tools (17%). Blood urea (>100), serum Creatinine (>4) in 44% and 46% respectively. Hb <10 gm/dl in 54%. WBC count >12000 in 65%. Sepsis and gastroenteritis are leading medical causes 25% and 12% respectively. Surgical causes are 14% and obstetrics causes are 11%.

Conclusions: AKI remains a common disorder among critically ill patients Consistent with other studies from developing world; this study has also shown that infections, nephrotoxins and gastroenteritis are the primary causes of AKI at our institute. Most of these causes can be prevented with simple interventions such as health education on oral rehydration, quality prenatal and emergency obstetric care, appropriate management of infections and taking appropriate precautions when prescribing potentially nephrotoxic medications.


Keywords


AKI, Blood urea, Gastroenteritis, Oliguria, Sepsis

Full Text:

PDF

References


Ibrahim A. Clinical profile and outcome of patients with acute kidney injury requiring dialysis: an experience from a haemodialysis unit in a developing country. BMC Nephrol. 2016;17:91.

Susantitaphong P. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol. 2013;8:1482-93.

Mehta RL, Kellum JA, Shah SV. Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31.

Chugh KS. Changing trends in acute renal failure in third-world countries-Chandigarh study. Q J Med. 1989;73(272):1117-23.

Thadani R, Pascaul M, Bonvette VB. Acute renal failure. New Eng J Med. 1996:30;1448-51.

Liu KD, Chertow GM. Acute renal failure. In: Fauci AS, Braunwald E, Kaspar DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw Hill; 2008:1752-1761.

Kaufman J, Dhakal M, Patel B, Hamburger J. Community-acquired acute renal failure. Am J Kidney Dis. 1991;17:191-8.

Jayakumar M, Prabahar MR, Fernando EM, Manorajan R, Venkatraman R, Balaraman V. Epidemiologic trend changes in acute renal failure-a tertiary center experience from South India. Ren Fail. 2006;28:405-10.

Anandh U, Renuka S, Somiah S, Vincent L. Acute renal failure in the tropics: emerging trends from a tertiary care hospital in South India. Clin Nephrol. 2003;59:341-4.

Molitoris BA, Levin A, Warnock DG. Improving outcomes from acute kidney injury. J Am Soc Nephrol. 2007;18:1992-4.

Balafa O, Andrikos E, Tseke P, Tsinta A, Pappas E, Kokkolou E, et al. Outcome and epidemiology of hospital-acquired acute renal failure. Bantao J. 2007;5(2):55-7.

Kapadia MP. A study of clinical profile of patients with acute kidney injury in a tertiary care centre. Int J Adv Scient Res. 2016;2(8):160-6.

Mataloun SE, Machado FR, Senna APR, Guimarães HP, Amaral JLG. Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit; Crit Care. 2003;7(Suppl 3):45.

Mehta RL, Pascaul MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TP, et al. The program to improve care in acute renal disease (PICARD). Spectrum of acute renal failure in the intensive care unit. the PICARD experiences. Kidney Int. 2004;66(4):1613-21.

Eswarappa M, Gireesh MS, Ravi V, Kumar D, Dev G. Spectrum of acute kidney injury in critically ill patients: a single centre study from South India. Indian J Nephrol. 2014;24(5):280-5.

Umesh L. Acute kidney injury: Experience from a state run tertiary care centre in Southern India. Int J Med Res Health Sci. 2016;5(5):83-7.

Kashinkunti MD. Clinical spectrum of Acute Kidney injury: A study from tertiary care hospital. Int J Pharmaceut Biol Res. 2013;4(4):165-9.