A study of etiological and clinical profile of patients with acute kidney injury and various factors associated with mortality: A single centre study

Manohar Lal Prasad; Prajit Mazumdar; Divakar Kumar; Malyaban Das

Volume : VII, Issue : IX, September - 2018

A study of etiological and clinical profile of patients with acute kidney injury and various factors associated with mortality: A single centre study

Manohar Lal Prasad, Prajit Mazumdar, Divakar Kumar, Malyaban Das

Abstract :

Introduction:Acute kidney injury due to any cause is associated with major inpatient morbidity and mortality. AKI complicates nearly 5% of the hospitaladmissions and up to 30% of ICU admissions

Materials and methods:We did a cross sectional descriptive study conducted on 60 patients admitted with a diagnosis of acute kidney injury in the department of medicine and dialysis unit of Rajendra Institute of medical sciences, Ranchi between January 2018 to july 2018

Results:Out of total 60 patients, 24 patients died and 36 patients survived.Patients in the age group of > 70 years had comparatively higher mortality rates(66.7%).

Out of 60 cases studied, 45 were due to medical causes, rest due to surgical and obstetric causes. Among the 45 cases of medical causes, complicated malaria was most common accounting for 24 cases (53.5% of medical causes) followed by snake bite.Among the causes of acute kidney injury, complicated malaria was the major cause leading to mortality.

Out of 60 patients for hemodialysis was done for 24 (40 %) AKI cases. The remaining 36 cases were treated conservatively. There was significant mortalty in patients undergoining hmd . 16 out of 24 patients undergoining haemodialysis died (66.7%) as compared to conservative treatment group.

24 out of 60 patients had various comorbid conditions and risk factors –most common was diabetes mellitus followed by hypertension and ischemic heart disease .There was significant increase in mortality (66.7%) in patients with comorbid conditions as compared to those without it.

There is a highly significant (p<0.001) difference in the outcome pattern of acute kidney injury patients who are having hyperkalemia when compared to those who are normokalemic and those having dearranged urea and ceratinine at admission.

Conclusion:Patients in the age group of > 70 years had comparatively higher mortality rates . Out of 60 cases studied, complicated malaria accounted for majority of cases followed by snake bite and higher mortality was seen in the malaria group as compared to other causes which can be attributed to the fact that Jharkhand is a malaria endemic zone and hence early treatment with antimalarials should be given to decrease the incidence of AKI. Patients with hyperkalemia, comorbid conditions and dearranged urea and ceratinine at admission had higher mortalty rates .