Medical causes of acute kidney injury- clinical and therapeutic aspects in constanta county

Abstract

Abstract Introduction. Acute kidney injury represents an important clinical syndrome within nephrology, approximately 5% of hospitalised patients being affected. Establishing a diagnosis for acute kidney injury can be challenging and requires many steps. A complete and correct diagnosis is essential for appropriate therapy and, ultimately, the patient’s prognosis. Methods. An objective of this study is to determine the presentation of certain characteristics for the diagnosis of acute kidney injury. It is also intended to show the therapeutic methods undertaken for patients presenting with acute kidney injury, as well as evolution under therapy. Results. The most common causes of acute kidney injury were medical causes and within that category, cardiovascular diseases were the most common etiological factor (18%). Nephropathies represented a minority, with acute pyelonephritis, responsible for 5% of medical causes, and acute glomerulonephritis accounting for 6%. Hemodialysis was initiated only in 15% of patients. The rest of the patients were treated conservatively and responded favourably to this therapeutic approach. The etiological factors that had the greatest number of patients requiring hemodialysis were Rifampicin administration and leptospirosis (~20% each). Conclusions. The clinical characteristics of acute kidney injury are variable and are usually specific to the etiology of the disease. The most common causes were cardiovascular diseases (18%). The therapeutic approach was rather conservative. Hemodialysis was instituted only in 15% of the patients. Almost 5% of all patients evolved to chronic kidney disease in a variable period of time, and the overall mortality was 18%, mainly due to infections and cardiovascular complications.