Intermittent hemodialysis for patients with acute kidney injury (AKI): Outcome in a tertiary level hospital

Abstract

Introduction: Acute kidney injury (AKI) is the abrupt loss of kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes. In developing countries, community acquired AKI is common than AKI in hospitalized septic patients. Most patients with AKI recover renal function conservatively yet few require renal support with intermittent Hemodialysis (HD). We conducted a study in a tertiary level hospital to find out the etiology and outcome of the patients presenting with AKI who required dialysis.Methods: This is a descriptive follow up study of the patients who needed renal replacement therapy in the form of HD presenting to our Nephrology unit of the hospital from Jan 2015 to Dec 2016, i.e. over a period of two years. Consent was taken from both the institution as well as the patients for the evaluation of data. Patients were followed up for at least three months from the time of enrolment. Data were tabulated and analysed using SPSS software.Results: Total 50 patients were included in the study, out of which 67% were male. The mean age of the patients was 54.54 years (SD±18.6). Hypertension was present in 44% and Diabetes in 18% as comorbidities. The commonest etiologies were urinary tract infection (30 %), acute gastroenteritis (24%) and obstructive uropathy (18%). The mean creatinine level at the time of nephrology consultation, maximum level and at the time of discharge were 6.5 (SD ± 2.62), 7.3 (SD ± 2.13) and 2.2 (SD ± 1.75) respectively. Uremia with anuria was the most common reason for the initiation of HD 54% cases. The mean number of intermittent HD used was 3.36. Out of total patients, 68% had complete recovery, 26% died and 6% had persistent renal dysfunction at the end of three months.