Clinical profile and outcomes of acute kidney injury patients in an intensive care unit in India

Authors

  • Vivek S. Narayan Pillai Department of Cardiology, Government Medical College, Kannur, Kerala, India
  • C. Joe Varghese Department of Medicine, KMC, Mangalore, Karnataka, India
  • Christopher C. Pais Department of Medicine, KMC, Mangalore, Karnataka, India
  • Vijay Gopal Rai Department of Medicine, KMC, Mangalore, Karnataka, India
  • Mahabala Chakrapani Department of Medicine, KMC, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20204481

Keywords:

Acute kidney injury, Sepsis, Hemodialysis, Conservative therapy

Abstract

Background: The limited epidemiological and outcome data of acute kidney injury (AKI) is available in developing countries. The current single-center study determined the clinical profile of AKI by attempting to identify the presenting symptoms, etiologies, treatment modalities, and disease prognosis in patients admitted in intensive care unit at a tertiary care center in Mangalore, India.

Methods: This retrospective study enrolled 70 AKI patients between October 2001 and October 2003, admitted at Wenlock district hospital, Mangalore, KMC hospital Attawar, Mangalore and KMC hospital, Jyothi circle, Mangalore, having a serum creatinine level greater than 1.4 mg/dl and blood urea greater than 53 mg/dl.

Results: Amongst the enrolled patients, 45.7% of patients were 40-60 years old and 49 were males with no significant (p=0.412) gender difference. The most common presenting symptom was diminished micturition present in 47.1% of patients and the most common etiology of AKI was sepsis found in 27.1% of patients with the highest (17.1%) mortality. Amongst the patients who underwent conservative treatment (n=52) the mortality rate was 42.8%, while in those who underwent hemodialysis (n=18) the mortality rate was 4.2%. The overall survival rate in the study was 52.9%.

Conclusions: The epidemiological data obtained in this study is similar to the previous studies in India with hemodialysis appearing to have better disease outcomes compared to conservative therapy.

References

Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W, et al. Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol: JASN. 2007;18(4):1292-8.

Ponce D, Balbi A. Acute kidney injury: risk factors and management challenges in developing countries. Int J Nephrol Renovascular Dis. 2016;9:193-200.

Cerda J, Bagga A, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nature Clin Practice Nephrol. 2008;4(3):138-53.

Case J, Khan S, Khalid R, Khan A. Epidemiology of acute kidney injury in the intensive care unit. Crit Care Res Prac. 2013;479730.

Gurjar M, Baronia AK, Azim A, Prasad N, Jain S, Singh RK, et al. Septic acute kidney injury in critically ill Indian patients. Ind J Crit Care Med. 2013;17(1):49-52.

Eswarappa M, Gireesh MS, Ravi V, Kumar D, Dev G. Spectrum of acute kidney injury in critically ill patients: A single center study from South India. Ind J Nephrol. 2014;24(5):280-5.

Korula S, Balakrishnan S, Sundar S, Paul V, Balagopal A. Acute kidney injury-incidence, prognostic factors, and outcome of patients in an Intensive Care Unit in a tertiary center: A prospective observational study. Ind J Crit Care Med. 2016;20(6):332-6.

Singh TB, Rathore SS, Choudhury TA, Shukla VK, Singh DK, Prakash J. Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study. Ind J Nephrol. 2013;23(1):24-9.

Priyamvada PS, Jayasurya R, Shankar V, Parameswaran S. Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill: Experience from a Tertiary Care Center. Ind J Nephrol. 2018;28(6):413-20.

Mahajan S, Tiwari S, Bharani R, Bhowmik D, Ravi S, Agarwal SK, et al. Spectrum of acute renal failure and factors predicting its outcome in an intensive care unit in India. Renal Failure. 2006;28(2):119-24.

Piccinni P, Cruz DN, Gramaticopolo S, Garzotto F, Dal Santo M, Aneloni G, et al. Prospective multicenter study on epidemiology of acute kidney injury in the ICU: a critical care nephrology Italian collaborative effort (NEFROINT). Minerva anestesiologica. 2011;77(11):1072-83.

Wing AJ, Broyer M, Brunner FP, Brynger H, Challah S, Donckerwolcke RA, et al. Combined report on regular dialysis and transplantation in Europe, XIII, 1982. Proceedings of the European Dialysis and Transplant Association European Dialysis and Transplant Association. 1983;20:2-75.

Avasthi G, Sandhu JS, Mohindra K. Acute renal failure in medical and surgical intensive care units--a one year prospective study. Renal Failure. 2003;25(1):105-13.

Lima RS, da Silva Junior GB, Liborio AB, Daher Ede F. Acute kidney injury due to rhabdomyolysis. Saudi J Kidney Dis Transplant. 2008;19(5):721-9.

Chugh KS, Singhal PC, Sharma BK, Mahakur AC, Pal Y, Datta BN, et al. Acute renal failure due to intravascular hemolysis in the North Indian patients. Am J Med Sc. 1977;274(2):139-46.

Sural S, Sharma RK, Singhal MK, Kher V, Gupta A, Arora P, et al. Acute renal failure in an intensive care unit in India--prognostic factors and outcome. J Nephrol. 1999;12(6):390-4.

Prakash J, Murthy AS, Vohra R, Rajak M, Mathur SK. Acute renal failure in the intensive care unit. J Assoc Phys India. 2006;54:784-8.

Maxvold NJ, Bunchman TE. Renal failure and renal replacement therapy. Crit Care Clin. 2003;19(3):563-75.

Downloads

Published

2020-10-20

Issue

Section

Original Research Articles