Spectrum of Acute Kidney Injury in a Nephrology Unit
Background: To identify etiologic factors causing
acute kidney injury (AKI) in our local population that
were admitted to tertiary care nephrology unit over one
Methods: In this prospective cohort study adult
patients with elevated serum creatinine, evaluated at least
twice,were included. Workup for glomerulonephritis
included complements levels, ANA, Anti dsDNA,
ANCA,AntiGBM, SPEP. Renal biopsy was performed for
suspected RPGN/Vasculitis, AIN, unexplained AKI.Renal
replacement therapy was initiated for standard
indications. Decreased renal perfusion was diagnosed
when blood pressure was less than 90/60 mmHg, signs of
volume depletion and severe cardiac failure. Urine output
less than 400ml/day was taken as oliguria. The AKI
definition and diagnosis was based on RILFE criteria ,i.e,
an abrupt (1 to 7 days) and sustained (more than 24 hours)
decrease in kidney function.
Results: Majority (62%) were male. Majority of the
patients (87.1%) were in failure category. Infection/sepsis
was the most common etiology (44.6 %), followed by drugs
(10.5%),gastroenteritis (10.2%),surgical cases (8.8%) and
obstructive nephropathy (7.5 %). Mortality was 39.1%,
reflecting critical condition and markedly deranged renal
Conclusion: AKI is a major public health challenge. It
is associated with high morbidity and mortality.
Infection/sepsis is the predominant etiological factor
causing AKI in our patients. Combating
infections/communicable diseases is crucial in preventing
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