Acute Kidney Injury is A Risk Factor among Type 2 Diabetic Patients after UTI due to Extended-Spectrum Beta-Lactamase Producing Organisms

Abstract

Background: Urinary tract infections (UTIs) are very communal, and patients with diabetics develop UTIs more frequently. Acute kidney injury (AKI) can be a complication of UTI. This study is designed to determine whether Urinary tract infections because of extended-spectrum beta-lactamase (ESBL) could be a risk factor of acute kidney injury in individuals with type-II diabetes mellitus. Methods: This case study was conducted in the Outpatient department of Diabetes Hospital Peshawar and Nishter Hospital Multan for duration of six months from August 2020 to January 2021. People of type II diabetes were assessed with culture confirmed UTI. The cases of UTI patients complicated with AKI were included in the study group, and people without AKI were taken as a control group. ESBLs positivity from isolated organisms have been assessed as risk factors for AKI. A total of 140 subjects were selected with equal distribution in two groups. The group A has UTI complicated with AKI and group B included has patients without AKI but with UTI. Results: UTI was diagnosed in 140 cases among type-II diabetic patients with 2:4 male to female ratio. The duration and mean age of diabetes mellitus were 8.60±5.35and55.80±14.10 years, correspondingly. The strongest common etiological factor was Escherichia coli (60.7%), trailed by Klebsiella pneumoniae (11.4%). In ESBL positive organism; E. coli was present in 81.4% and K. pneumoniae in 10% of individuals. Of the 140 UTI cases, AKI was observed in 70 (50%); out of which 48 (62.5%) were ESBL-positive microorganisms and 22 (22/70, 31.43%) for non-ESBL microorganisms. Conclusions: Nearly50% of the patients with type-II diabetes mellitus and UTI had ESBL-positive microorganisms as etiological mediators in this analysis. Owing to the presence of ESBL-positive microorganisms, UTI was the main cause of AKI and is a strong risk factor. Keywords: ESBL, Acute kidney injury, UTI, type 2 diabetes, risk factor.