A study on clinical profile and outcome of acute kidney injury of patients admitted in the intensive care unit of a tertiary care centre

Abstract

Background: Acute kidney injury is one of the most common conditions seen in the ICU setup. We come across acute kidney injury in patients on admission to the ICU initially, or as a development during the course of the disease, as a complication. Aim & Objectives: There is a need to study the most common diseases/ conditions causing AKI which can help in detecting the acute kidney injury at the earliest, and which will help in reducing the morbidity of patients. Methodology: This is a prospective study of all the patients of AKI fitting into the inclusion criteria of the study who were admitted in the intensive care unit of NRI Medical College and Hospital, Guntur, a tertiary care centre, during the period of November 2019 to October 2020. Results: In the present study, Incidence of AKI in the ICU was 6.7% with a male preponderance. Etiology of AKI was multifactorial. Incidence of medical related AKI was highest followed by medico surgical cases. Mortality was more in medical cases than medico surgical cases. Various comorbid factors play a role in final outcome of AKI. Type 2 diabetes mellitus was the highest predictor of mortality among the comorbid illnesses. Higher mortality was observed in the elderly age group. Most of the patients presented with hypotension and metabolic acidosis. In the setting of ICU despite of adequate treatment strategies including inotropes, dialytic modality and ventilator support, sepsis and multiorgan failure were the major causes of mortality in these patients. Among the risk, injury and failure groups, maximum number of patients from the failure group progressed to CKD and also had a terminal outcome. Mortality of patients of AKI in the ICU in our study was 8.14%. Conclusion: There is a need to avoid, or at the least, use the nephrotoxic drugs with caution in such patients. There is a constant relationship between the disease severity on the renal functions and the grade of AKI on the outcome of the disease. Hence there is a need to detect, evaluate and treat AKI at the earlier stages of the disease.