CLINICO-LABORATORY CHARACTERISTICS, RISK FACTORS AND OUTCOME OF ACUTE KIDNEY INJURY

OBJECTIVE: To determine the clinico-laboratory characteristics, risk factors and outcome related to acute kidney injury (AKI) in hospitalized patients. METHODS: This prospective study on 101 consecutive patients admitted to the Northwest General Hospital & Research Centre, Peshawar, Pakistan was carried out from January-March 2019. Patients were staged according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines and outcomes were measured in terms of in-hospital mortality and change in KDIGO staging. RESULTS: Majority (n=57/101; 56.43%) were males. Mean age of patients was 57.90±16.93 years. Twenty-seven (26.73%) patients were in AKI stage-I, 29 (28.71%) in stage-2 and 45 (44.55%) were in stage-3. Hypertension (n=74/101; 73.27%) was the commonest co-morbid condition. Sepsis (n=39/101; 38.61%) and hypovolemia (n=21/101; 20.8%) were most common risk factors for AKI. There was complete recovery in 43 (42.57%) patients. In-hospital mortality was 6.9% (n=7/101) and 57.1% (n=4/7) of these patients had KDIGO stage-3. Serum creatinine levels declined in 22 (21.78%) cases, remained static in 23 (22.8%) and worsened in 06 (5.9%) cases. Male gender and presence of hypovolumia (p<0.05) significantly differed in survivors compared to non-survivors. Furthermore, factors associated with declined in serum creatinine included stage-II AKI and length of hospital stay, while stage-II and III AKI on admission, absence of oliguria crude odd ratio (cOR: 2.681, p=0.027, 95% CI: 1.12-6.44)  and serum creatinine levels on admission (cOR: 0.668, p<0.001, 95% CI: 0.54-0.83) were associated with complete recovery. CONCLUSION: Sepsis and hypovolemia constituted the major risk factors. Gender and hypovolemia were the significant factors between the survivors and non-survivors.