Etiological variability affecting the clinical outcomes of patients admitted with acute kidney injury in a tertiary care hospital

Objectives: The objectives are to study the clinical profile of patients admitted with acute kidney injury (AKI) and to study the determinants of the outcomes of patients with AKI. Subjects and Methods: The study was done in setting of tertiary care hospital in Department of Nephrology. It is a prospective observational study. A total of 220 patients who were admitted with community AKI in a tertiary care hospital were evaluated, and data were collected and analyzed. Patients were evaluated and followed up and if indicated were dialyzed until recovery. Primary outcomes were in-hospital mortality, complete recovery, and dialysis dependency at 3 months. Apart from these etiological profile, mortality of patients with various etiology, their RIFLE staging was assessed. Results: of 220 patients studied, 191 (86.81%) survived and 29 (13.19%) expired, 93 (42.27%) patients required dialysis and 123 (57.7%) did not require dialysis with oligoanuria being the most common (24.5%) indication for dialysis and gastroenteritis was the most common etiology of AKI in 60 (27.3%) reflecting the high incidence of disease in community, followed by sepsis 31 (14.1%), pyelonephritis 27 (12.3%), and snakebite and obstetrics 19 (8.6%) each. Among patients who died, patients with sepsis had highest mortality 11 (35.5%) and gastroenteritis and acute febrile illness had least mortality (1.7% and 0%), respectively, majority of patients (59.5%) were in RIFLE Stage 3 and they had the highest mortality 23 (17.6%). A significant association was observed between the etiology and mortality (P < 0.005). Conclusions: We conclude that underlying cause of AKI is important determinant of the clinical outcome where we found that patients with gastroenteritis had better outcome than other etiology of AKI.