Etiological spectrum of acute kidney injury and adverse outcome: A single-center observation

Abstract

Background The present study aims to evaluate the etiological spectrum with clinicopathological parameters and adverse outcomes of acute kidney injury (AKI). Methods A hospital-based prospective observational study was conducted for a spectrum of AKI in 103 AKI patients and their AKI-associated adverse outcomes. The AKI patients were included as per the KDIGO definition. The patients with a known chronic kidney disease (CKD) were excluded from the study population. A clinicopathological association with AKI was observed. Adverse outcomes and the need for renal biopsy were recorded in 3 weeks followed up to 6 months. Results A single-center study recorded that the incidence of AKI was 8.6% with a mean age of 34 ± 16 years. The cause of AKI due to medical reasons was maximum (70.8%), followed by obstetric (21.3%) and surgery (7.7%). The AKI mortality rate was 16% (P < 0.05). Renal biopsy in 34 cases showed that acute tubular necrosis was higher (38%), followed by acute cortical necrosis (23%). The spectrum of AKI was very diverse. In the 6-month follow-up, the adverse outcome was observed in 27.2% of patients, where the mortality rate was 16.5% and 10.7% of patients progressed to CKD. Conclusion The spectrum of AKI was diverse among the population, and most of the etiologies are preventable. This alarms the need for better preventive strategies with a better referral system. The obstetric population with AKI, which majorly leads to either mortality or progression to CKD, is the section that seeks more attention.

Keywords

• acute cortical necrosis
• acute tubular necrosis
• community-acquired aki
• thrombotic microangiopathy