Profile of Acute Kidney Injury Patients Admitted to a Tertiary Care Centre in Urban South India: A Prospective Observational Study.
Acute kidney injury (AKI) is a common clinical syndrome associated with significant morbidity, mortality, and healthcare burden. Data regarding the prevalence, causes, and outcomes of AKI in tertiary care settings in South India remain limited. This study aimed to evaluate the prevalence, aetiology, clinical profile, and in-hospital outcomes of AKI among adults admitted to a tertiary care centre.
This prospective observational study was conducted over 18 months among adult patients admitted to the general medicine wards of a tertiary care hospital in South India. Patients fulfilling the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 criteria for AKI were enrolled. Demographic, clinical, laboratory, and outcome data were collected using a structured proforma. AKI was classified as pre-renal, intrinsic renal, or post-renal based on clinical and laboratory findings. Statistical analysis was performed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA), with p<0.05 considered statistically significant.
Among 2,427 hospital admissions, 65 patients met KDIGO criteria for AKI, yielding a prevalence of 2.67%. Most patients were male (44, 67.7%), and the most affected age group was 51-65 years (24, 36.9%). Type 2 diabetes mellitus (29, 44.6%) and hypertension (26, 40.0%) were the most common comorbidities. Sepsis was the leading aetiology (32, 49.2%), followed by cardiac failure (12, 18.5%) and chronic liver disease (5, 7.7%). Pre-renal AKI accounted for 34 (52.3%) cases, intrinsic renal AKI for 28 (43.1%), and post-renal AKI for three (4.6%). Complete renal recovery occurred in 28 (43.1%) patients, partial recovery in 22 (33.8%), and in-hospital mortality in 15 (23.1%). Oliguria (p=0.01), hypotension (p<0.001), elevated leukocyte count (p<0.01), blood urea nitrogen (p<0.01), peak serum creatinine (p<0.01), urine sodium (p=0.01), and fractional excretion of sodium (p<0.01) were significantly associated with adverse outcomes.
AKI remains an important cause of morbidity and mortality among hospitalised adults. Sepsis was the predominant aetiology, while hypotension, oliguria, and severe biochemical abnormalities were associated with poor outcomes. Early recognition and prompt management of high-risk patients may improve renal recovery and reduce mortality.
This prospective observational study was conducted over 18 months among adult patients admitted to the general medicine wards of a tertiary care hospital in South India. Patients fulfilling the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 criteria for AKI were enrolled. Demographic, clinical, laboratory, and outcome data were collected using a structured proforma. AKI was classified as pre-renal, intrinsic renal, or post-renal based on clinical and laboratory findings. Statistical analysis was performed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA), with p<0.05 considered statistically significant.
Among 2,427 hospital admissions, 65 patients met KDIGO criteria for AKI, yielding a prevalence of 2.67%. Most patients were male (44, 67.7%), and the most affected age group was 51-65 years (24, 36.9%). Type 2 diabetes mellitus (29, 44.6%) and hypertension (26, 40.0%) were the most common comorbidities. Sepsis was the leading aetiology (32, 49.2%), followed by cardiac failure (12, 18.5%) and chronic liver disease (5, 7.7%). Pre-renal AKI accounted for 34 (52.3%) cases, intrinsic renal AKI for 28 (43.1%), and post-renal AKI for three (4.6%). Complete renal recovery occurred in 28 (43.1%) patients, partial recovery in 22 (33.8%), and in-hospital mortality in 15 (23.1%). Oliguria (p=0.01), hypotension (p<0.001), elevated leukocyte count (p<0.01), blood urea nitrogen (p<0.01), peak serum creatinine (p<0.01), urine sodium (p=0.01), and fractional excretion of sodium (p<0.01) were significantly associated with adverse outcomes.
AKI remains an important cause of morbidity and mortality among hospitalised adults. Sepsis was the predominant aetiology, while hypotension, oliguria, and severe biochemical abnormalities were associated with poor outcomes. Early recognition and prompt management of high-risk patients may improve renal recovery and reduce mortality.