Spectrum of Acute Kidney Injury in Critically Ill Patients in Medical Icu: A Single Center Hospital-Based Study From North-Eastern India

Abstract

BACKGROUND Acute Kidney Injury (AKI) is a rapid and usually reversible decline in glomerular filtration rate (GFR) that may occur in the setting of either preexisting normal kidney functions or pre-existing damaged kidney. AKI in the ICU is associated with mortality as high as 45-50%, with dialysis dependence, with reduced quality of life, and with excess utilization of health resources. The aim of this study was to analyse the incidence, prognostic factors, and outcome of AKI in critically ill patients in the setting of a medical ICU. MATERIALS AND METHODS A single centered prospective observational study was carried out at Silchar Medical College and Hospital, Silchar, Assam for a period of 2 years 2015-2017. A total of 200 patients with AKI, defined by RIFLE criteria, during this period, who met our study requirements were evaluated. RESULTS AKI was predominantly encountered in older males. Diabetes, hypertension, coronary artery disease were the most commonly prevalent comorbidities. Sepsis was the most common cause of AKI, accounting for 38.6% of patients. RRT was required by 34.5% patients. In the hospital, mortality was 32.5%. CONCLUSION AKI has a tremendous effect on prognosis. Septic AKI exerts an important and independent increase in the risk for hospital death. A meticulous approach is needed for the better outcome in ICU settings.