Introduction:
Acute kidney injury (AKI) presents with varying patterns across different regions of India. While hospital-acquired AKI (H.A.A.K.I.) is commonly associated with drug-induced causes, sepsis, and post-surgical complications, community-acquired AKI ( C.A.A.K.I. ) is predominant in tropical regions like India, often linked to dehydration, infections, and environmental factors. This study aimed to evaluate the etiology, clinical characteristics, and short-term outcomes of C.A.A.K.I. in adults at a tertiary care hospital in Southern Rajasthan.
Methods:
We conducted a prospective observational study between March 2023 and August 2024, including 427 adult patients admitted to the medical wards with a diagnosis of C.A.A.K.I. , based on the 2012 KDIGO criteria. Patients developing AKI beyond 48 hours of admission or with chronic kidney disease were excluded. Serum creatinine and urine output were monitored, with daily assessments of clinical parameters such as hypotension, oliguria, sepsis, and the need for renal replacement therapy (RRT).
Results:
The mean age of the patients was 45.5 ± 14.8 years, with a male predominance (79%). Of the 427 patients, 201 (47.1%) had an infective etiology, 213 (49.9%) had a non-infective cause, and 13 (3.0%) had intrinsic renal pathology. Acute pyelonephritis (21.3%) and snakebite (22.7%) emerged as the leading infective and non-infective causes of C.A.A.K.I. , respectively. Mortality was observed in 64 patients (15%), with significant associations found between mortality and the presence of hypotension, mechanical ventilation, thrombocytopenia, and anuria. The median hospital stay was 10 days, with complete renal recovery in 43% of the patients.
Conclusions:
In Southern Rajasthan, snakebite and acute pyelonephritis are the predominant causes of C.A.A.K.I. . These findings underscore the importance of addressing environmental and infectious risk factors to reduce the burden of C.A.A.K.I. , which remains associated with considerable morbidity and mortality. Further research is needed to develop preventive strategies and improve long-term outcomes for C.A.A.K.I. patients.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.