CLINICAL CHARACTERISTICS AND OUTCOMES OF SEVERE ACUTE KIDNEY INJURY IN A TERTIARY CARE HOSPITAL- A TEN YEAR RETROSPECTIVE STUDY

8 Feb 2025 12 a.m. 12 a.m.

WCN25-AB-3452, Poster Board= SAT-527

Introduction:

AKI occurs in 5.7 -24% of ICU patients and is commonly associated with multiorgan failure, sepsis, renal hypoperfusion, preexisting renal disease. Renal Replacement therapy (RRT)is reportedly used in 51-82% of patients with AKI in ICU patients. Mortality of patients with AKI in ICU ranges from 46-60% and use of vasopressors, mechanical ventilation, shock are independent predictors of mortality. An estimated 2 million people worldwide die of AKI every year, whereas AKI survivors are at increased risk of developing chronic kidney disease (CKD) and end-stage renal disease (ESRD) — conditions that carry a high economic, societal and personal burden. Understanding the clinical characteristics and outcomes of patients with severe AKI is essential for optimizing management strategies and improving patient outcomes.

The primary objective of this study is to examine the clinical characteristics and outcomes of patients with severe AKI in a tertiary care hospital.

Methods:

STUDY DESIGN: Retrospective Record based study

STUDY SETTING: Tertiary care public sector teaching hospital

STUDY PATICIPANTS: Case records of patients with severe AKI

admitted during the study period

STUDY DURATION: August 2014 to August 2024 (10 years)

INCLUSION CRITERIA:

Age > 18 years

Patients with AKI stage 3 admitted during the study period

Case records availability

EXCLUSION CRITERIA:

Patients with established diagnosis of CKD

Case records unavailability

AKI stage 1 & 2

Age less than 18 years.

METHODOLOGY:

Patient demographics, clinical characteristics, etiology, renal replacement, vasopressor use, mechanical ventilation were recorded. Biochemical and hematological parameters at the onset of RRT were noted. patients are further followed up with renal function tests, 24 hr urinary protein, USG abdomen.

Two modes of RRT were given to our patients. Indications of RRT were as per literature.

RRT received as intermittent hemodialysis or peritoneal dialysis. Indications for RRT is as per literature.

Primary outcomes assessed were mortality, complete recovery, progression to Acute Kidney Disease (AKD).

Results:

Out of total 6457 patients, 2376(36.8%) patients had mortality, 1052(16.3%) patients recovered within 1 week and 3029(46.9%) patients progressed to AKD.

TABLE 1: Baseline characteristics in our study:

TABLE 2: ETIOLOGY OF AKI IN OUR STUDY:

TABLE 3: Baseline lab parameters in our study:

TABLE 4: Distribution of etiologies in AKI patients who met with mortality, recovered before day 7 and progression to AKD

TABLE 5: Characteristics of AKI patients among the mortality and survivor group.

TABLE 6: Characteristics of AKI in patients among the survived group

Conclusions:

Sepsis is the most common etiology of AKI in our study, followed by tropical AKI and cardiac related causes.

Out of total 6457 patients of AKI, 16.3% of patients recovered, 36.8% of patients had mortality, and 46.9% of patients progressed to AKD.

Factors affecting Mortality in our study were lower serum albumin, higher q SOFA scores, patients on peritoneal dialysis, ionotrope support and need for mechanical ventilation.

Younger age, presentation with breathlessness and oliguria, raised liver function tests (LFT), lower serum potassium levels were associated with progression to AKD among the survivors in our study.

There is significant association of underlying co morbidities with progression to AKD but not with mortality.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.