Clinical profile and outcome of acute kidney injury in a tertiary care center of eastern Nepal

Abstract

Background Acute kidney injury (AKI) is a global problem and it is encountered both in community and in-hospital patients. AKI has caused very significant damage to the health sector with high morbidity and mortality rates as well as a financial burden to the family. AKI contributes to a 3% incidence of end-stage renal disease (ESRD). Sepsis and hypovolemia-associated ischemia is the most common cause of AKI.  AKI has various risk factors, modes of presentation and outcomes. Also, the prevalence varies across the different populations. There is a paucity of data about the clinical profile of AKI in the eastern part of Nepal. This study aims to assess the age, comorbid conditions, the severity of AKI, mode of treatment, and outcome of patients with AKI admitted to the Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. Methods This is a cross-sectional analytical study conducted at a Nobel Medical College Teaching Hospital, Biratnagar, Nepal from July 2018 to June 2019 AD. Results In this study, 192 patients diagnosed with AKI were included. Male patients accounted for 52.7%. The mean age was 48.6±18.73 years. Most of the patients (74.5%) were below <60 years of age.  The average duration of hospital stay was 8 days. The common cause of AKI was sepsis in 71.9%. Diabetes mellitus (DM) was seen in 52.6% of patients. Most of the patients (41%) were at stage III AKI at the time of admission. Hemodialysis was done in 14.6% and 85.4% were managed conservatively. Average sessions of hemodialysis were 3.61. Complete recovery was seen in 69.8% of the patients. Conclusions We observed that early diagnosis, avoidance of nephrotoxic agents, and early, aggressive, and appropriate interventions result in improved patient outcomes. However late presentations of AKI have a higher hospital mortality rate.