Spectrum and Outcome of Acute Kidney Injury in Nonsurgical Cardiac Intensive Care Unit Patients: A Prospective Observational Study.

Abstract

Background and aims: This study has been conducted to investigate the spectrum, outcome and prognostic factors of acute kidney injury (AKI) in nonsurgical cardiac intensive care unit (CICU).

Patients and methods: Hospital-based single center prospective observational study with duration of 9 months (January/2023 to September/2023). Data recorded at baseline, 72 hours, day 7, at discharge and at 1 and 3 months after discharge.

Results: 194 AKI patients (incidence 15.45%), had mean hospital stay 9 ± 4 days, mean age 59.71 years, 84.0% male, 52.1% hypertensive and 47.9% diabetes mellitus. 73% had chest pain, 2.1% anuria, 40.20% shock and 8.2% required inotrope support. AKI was mainly community-acquired, nonoliguric, stage 2; due to type 1 cardiorenal syndrome secondary to acute myocardial infarction and heart failure. 92.3% had LV systolic dysfunction, 52.1% received diuretics and 16% had thrombolysis. 24 subjects received hemodialysis (HD) with mortality 5.6%. Major outcome was nonrecovery at discharge (50.5%), complete remission at 3 months (63.4%) and progression to chronic kidney disease (CKD) (27.8%,). Acute kidney injury staging and outcome was unaffected by discharge cardiac diagnosis. Severe AKI and HD requirement had significantly affected progression to CKD and mortality. Total leukocyte count and serum creatinine had significant connection with mortality. Moderate to severe AKI showed significant risk of subsequent cardiovascular events (p = 0.0008).

Conclusion: Acute kidney injury in cardiac ICU is mostly community-acquired and due to cardiorenal syndrome type 1. Majority achieved complete remission on follow-up. Moderate to severe AKI, often multifactorial, is significantly associated with progression to CKD, patient mortality and subsequent cardiovascular events.

How to cite this article: Saini N, Bhattacharjee K. Spectrum and Outcome of Acute Kidney Injury in Nonsurgical Cardiac Intensive Care Unit Patients: A Prospective Observational Study. Indian J Crit Care Med 2025;29(6):479-485.