Acute Kidney Injury in Diabetes Mellitus – Epidemiology, risk factors, and short-term outcomes – A study from a tertiary care hospital in south India

 

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Acute Kidney Injury in Diabetes Mellitus – Epidemiology, risk factors, and short-term outcomes – A study from a tertiary care hospital in south India

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rambrahma reddy
donthireddy
rambrahma reddy donthireddy rambrahmareddymbbs@gmail.com gandhi hospital nephrology hyderabad India *
manjusha yadla manjuyadla@gmail.com gandhi hospital nephrology hyderabad India -
sreekanth b sreedoc2000@gmail.com gandhi hospital nephrology hyderabad India -
srinivas p swathivasu194@gmail.com gandhi hospital nephrology hyderabad India -
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Diabetes mellitus (DM) is the most common cause of chronic kidney disease, which leads to end-stage renal failure worldwide. Glomerular damage, renal arteriosclerosis, and atherosclerosis are the contributing factors in diabetic patients, leading to the progression of kidney damage. However, Diabetes is a distinct risk factor for acute kidney injury (AKI) also and AKI is associated with faster advancement of renal disease in patients with diabetes. The risk factors of AKI in DM, the epidemiology and mortality/prognosis need further validation. 

Materials and Methods:.

Type of study:  Observational study.

Inclusion criteria:   All patients with AKI with Diabetes mellitus who were admitted to the Department of Nephrology, Gandhi Hospital from May 2023 to May 2025.

Exclusion criteria: Patients with CKD on Maintenance Hemodialysis with DM

Setting: Department of Nephrology, Gandhi Medical College, Secunderabad.

Study population: 496

Methodology:-

Data of the 496 patients admitted in the Department of Nephrology in view of AKI and AKI on CKD/DKD and with a history of Diabetes was obtained from medical records. Baseline data including age, gender, other comorbidities, duration of DM and the HbA1c, presence of micro and macrovascular complications were noted. Symptoms and indications of admission were recorded. Laboratory parameters on first day of ICU admission were included. Use of invasive and non-invasive ventilation, inotropes and RRT were recorded. All patients in KDIGO AKI stage III

Among 496 patients, the mean age of was 48 yrs with age range of 18-82years. Men constituted of 63.7% and women were 36.3% of the study population.

conclusion

●        The most common causes of AKI in DM is sepsis induced. Of all causes of sepsis, the most common was UTI (29 %) followed by LRTI.

●        However, the most etiology among the mortality population was LRTI with sepsis.

●        Duration of Diabetes and the HbA1c levels are important indicators of mortality and predicting outcome.

●        The mortality accounts to 26.6% in our study population

●        82.2% of study population progressed to AKD, which validate the impact of DM in acute kidney injury.


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