Abstract

Acute kidney injury: Experience from a state run tertiary care centre in Southern India

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 India. The study was conducted to identify the etiological factors, co-morbidities and mortality risk in AKI. We conducted prospective cross sectional analysis in 624 adult patients with AKI. The mean age was 48.96±18.3 years. AKI was predominantly encountered in ICU (Intensive Care Unit) patients. Diabetes, hypertension, COPD (Chronic Obstructive Pulmonary Disease), coronary artery disease were the most commonly prevalent co-morbidities. Out of the 624 patients, 460 were admitted with medical causes (73.7%), 124 with obstetrical causes (19.8%) and 40 (6.4%) with surgical causes. Sepsis was the most common medical cause for AKI accounting for 138(30%) of patients. Among pregnancy related AKI majority had puerperal sepsis 65 (52.41%) followed by pregnancy induced hypertension in 30(24.1%).There was increase incidence of acute gastroenteritis and parasitic infections during rainy seasons. Hemodialysis was required in 80% (n=499) of patients. The mean duration of hospital stay was 9.41±7.3 days. Multi-organ failure was seen in 106 (16.98%) patients. Among them 60 (63.6%) patients were expired. Our study highlights the AKI secondary to sepsis followed by pregnancy-related AKI was the most frequent etiological factors for AKI. Multi-organ failure, puerperal sepsis were accounted for the majority of mortality in AKI. AKI among these instances are largely preventable. The timely and aggressive management will certainly reduce the incidence of AKI.

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