Introduction:
Acute gastroenteritis, either bacterial or viral is a common cause of illness resulting in visits to the emergency department and outpatient clinics. It causes outbreaks in certain closed communities, such as nursing homes and schools, as well as community outbreaks when access to clean, safe drinking water is challenging, such as in summer months in developing countries. Norovirus is the most common cause of acute gastroenteritis and the second most common cause of hospitalization for acute gastroenteritis[1]. Acute Kidney injury (AKI) is a severe complication of acute diarrheal illness, and while it can be preventable with early hydration, it can cause an increased duration of hospitalization as well as increase patient morbidity and have negative long-term consequences. There is limited data on post diarrheal AKI epidemiology and outcomes. Early detection of AKI caused by AGE can significantly decrease mortality rates. We looked at the incidence of AKI and outcomes in patients admitted with AGE over the summer months.
Methods:
A single-center cross-sectional study enrolling patients admitted with AGE at R.L Jalappa Hospital, Tamaka, Kolar, the only tertiary care referral center in the district. Demography, comorbidity status, relevant history, and laboratory information were collected prospectively from February 2024 to June 2024 for the study. All adult patients>18 years of age admitted with diarrhoea and vomiting were included in the study. A total of 101 patients were eligible and included in the study. The study was stratified based on demographic data and kidney disease improving global outcome staging (KIDGO). The estimated sample size was 60 with a 95 % confidence interval. Patient and renal outcome was noted at the time of discharge.
Results:
As depicted in Table 1 and Fig 1 and 2 :
The mean age of patient was 58.3± 16.89 years with an overall male predominance. AKI was seen in 52.4% with most patients in KDIGO stage 1(37.7%) and KDIGO 3 staging observed in 33.9% patients. Dialysate support was required in 10 (18.8%), while the remaining patients were managed conservatively. At discharge, about 75 % of patients had shown complete recovery, while 20.8% had partial renal function recovery. Mortality rate was 1.8%.
Table 1:Demographic parameters
Fig 1: Stages of AKI in admitted patients.
Fig 2: Recovery from AKI at discharge
Conclusions:
In our short-term single-center study, 52.40 % of patients with acute GE had AKI while 19% of these patients required renal replacement therapy. Renal recovery rates were good. However, partial recovery was seen in 21%, and further observation and follow-up are necessary. This study emphasizes the fact that community-acquired AKI, which is largely preventable, remains a continuing challenge with early recognition and appropriate management strategies necessary for prevention.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.