Acute kidney injury in the pediatric ICU of a tertiary care hospital: Cross sectional observational study

Introduction: Acute kidney injury is a rare complication of pregnancy and is associated with high maternal morbidity and mortality. Obstetric factors associated with it are preeclampsia/eclampsia, sepsis, hemorrhage and dehydration. Here, we aim to find out the prevalence of complete recovery of renal function among obstetric patients with acute kidney injury. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from 1st July 2020 to 30th June 2021 where obstetric patients who had developed acute kidney injury were included and followed till 6 weeks of diagnosis. Ethical approvalwas obtained from Institutional Review Committee of Nobel Medical College and Teaching Hospital (IRC- NMCTH 437/2020). The convenience sampling method was used. Data entry and analysis were done using Statistical Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 66 obstetric patients with acute kidney injury, 45 (68.2%) (57-79.3 at 95% Confidence Interval) had complete recovery of renal function. Rate of renal function recovery in Stage 1, Stage 2 and Stage 3 acute kidney injury were 19 (90%), 19 (86%) and 7 (58%) respectively. The most common causes of acute kidney injury were Preeclampsia/eclampsia 18 (40%), sepsis 23 (28.8%) and hemorrhage 10 (22.2%). Conclusions: The prevalence of complete recovery in obstetric patients with acute kidney injury was similar to findings from other studies done in similar settings.

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Acute kidney injury and it's outcome following maternal near miss event: A prospective observational study from a tertiary care hospital

Obstetric Medicine ◽

10.1177/1753495x211069020 ◽

2021 ◽

pp. 1753495X2110690

Author(s):

Geetika Thakur ◽

Aruna Singh ◽

Vanita Jain ◽

Pooja Sikka ◽

Aashima Arora ◽

...

Keyword(s):

Acute Kidney Injury ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Kidney Injury ◽

Near Miss ◽

Care Hospital ◽

One Year

Purpose Haemorrhage, preeclampsia and sepsis are the leading causes renal dysfunction in women with a maternal nearmiss(MNM) complication. The study aimed to assess the prevalence, pattern and follow up of these women. Methods This was a hospital based prospective observational study, conducted over one year. All women with a MNM leading to acute kidney injury (AKI) were analysed for fetomaternal outcomes and renal function at 1 year of followup. Results Incidence of MNM was 43.04 per 1000 livebirths. 18.2% women developed AKI. 51.1% women developed AKI in the puerperal period. Most common cause of AKI was haemorrhage seen in 38.3% women. Majority of women had s.creatinine between 2.1 to 5 mg/dl and 44.68% required dialysis. 80.8% women recovered fully when the treatment was initiated within 24 h. One patient underwent renal transplant. Conclusion Early diagnosis and treatment of AKI results in full recovery.

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Acute Kidney Injury Secondary To Snake Bite In Patients Presenting To A Tertiary Care Hospital

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018051 ◽

2018 ◽

Vol 08 (03) ◽

pp. 168-171

Author(s):

Harish Kumar ◽

Adnan Bashir ◽

M Omer Sultan ◽

Khadijah Abid ◽

Nabeel Naeem Baig

Keyword(s):

Acute Kidney Injury ◽

Tertiary Care Hospital ◽

Medical Center ◽

Tertiary Care ◽

General Medicine ◽

Kidney Injury ◽

Snake Bite ◽

Outcome Variable ◽

Care Hospital ◽

Cross Sectional

Objective: To determine the frequency of Acute kidney injury secondary to snake bite in patients presenting to a tertiary care hospital. Subject and Methods: This was a descriptive cross-sectional study conducted at the department of General Medicine, Jinnah postgraduate medical center, Karachi, from 10th June 2015 to 10th Jan 2016. Patients with diagnosis of snake bite were enrolled. Detailed history, physical examination and biochemical measurements were recorded. Patients underwent serum creatinine levels for diagnosis of AKI. Results: One hundred and twelve patients fulfilling the inclusion criteria were included in this study.There were 90 (83.36%) males and 22 (19.64%) females. The mean ± standard deviation age of study population was 28±0.151 years. On analysis of risk factors it was observed that 33 (29.46%) patients were obese. On analysis of outcome variable, it was observed that 33 (29.46%) had AKI. Conclusion: Around 30% of patients who developed AKI were presented with history of snake bite. However, factors such as age, gender, duration and obesity were not related with the AKI.

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Frequency of hypertension among children having acute kidney injury (AKI) at A Tertiary Care Hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.01.4678 ◽

2021 ◽

Vol 28 (01) ◽

pp. 47-51

Author(s):

M Faisal Mehar ◽

Afsheen Asghar Khan ◽

Rushan Hassan ◽

Madiha Naz ◽

Bushra Iqbal ◽

...

Keyword(s):

Acute Kidney Injury ◽

Rural Areas ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Kidney Injury ◽

Cross Sectional Study ◽

Care Hospital ◽

Pediatric Medicine ◽

Very High Frequency ◽

Cross Sectional

Objectives: To know the frequency of hypertension among children having acute kidney injury (AKI) at a tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting: Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: 1st January to 31 December 2019. Material & Methods: A total of 718 children with AKI were included from department of Pediatric medicine, Nishtar Hospital, Multan. Once registered, study variables were noted along with systolic and diastolic blood pressure. Results: Of these 718 study cases, majority, 439 (61.1%) were male, 435 (61.0%) belonged to rural areas, 443 (61.7%) from poor socioeconomic status and 551 (76.7%) mothers were illiterate. Mean age was 4.33±2.56 years whereas mean body mass index was 23.58±3.17 kg/m2. Overall, family history of AKI was noted in 165 (23.0%) children. Hypertension was noted in 228 (31.8%) cases. Conclusion: Very high frequency of hypertension was seen in children presenting with AKI.

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Predictors of mortality in acute kidney injury patients admitted to medicine intensive care unit in a Rural Tertiary Care Hospital

Indian Journal of Critical Care Medicine ◽

10.4103/ijccm.ijccm_462_17 ◽

2018 ◽

Vol 22 (4) ◽

pp. 231-237 ◽

Cited By ~ 5

Author(s):

Amrish Saxena ◽

Shrikant Meshram

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Kidney Injury ◽

Care Hospital ◽

Predictors Of Mortality

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Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45161.13845 ◽

2020 ◽

Author(s):

VS Gaurav Narayan ◽

SG Ramya ◽

Sonal Rajesh Kumar ◽

SK Nellaiappa Ganesan

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care ◽

Kidney Injury ◽

Rapid Decline ◽

Care Hospital ◽

Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

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A CLINICAL STUDY OF ETIOLOGY, OUTCOME AND PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AMONG ICU ADMISSIONS IN RURAL TERTIARY CARE HOSPITAL

10.36106/gjra/9815424 ◽

2021 ◽

pp. 201-204

Author(s):

Shashikantha Shashikantha ◽

Sohil Sharda. ◽

Bernice Robert ◽

Gangurde Bhushan Daulatrao

Keyword(s):

Acute Kidney Injury ◽

Prognostic Factors ◽

Renal Disease ◽

Tertiary Care Hospital ◽

Chronic Renal Disease ◽

Tertiary Care ◽

Ventilatory Support ◽

Kidney Injury ◽

Care Hospital ◽

Study Results

INTRODUCTION: Acute kidney injury is a common occurrence in ICU admissions causing increased morbidity and mortality. Present study aimed to determine the causes and prognostic factors of acute kidney injury in intensive care unit. MATERIAL AND METHODS: This Hospital based Cross sectional Study was conducted at a tertiary care Hospital and Research Center, including 100 patients aged >18 years with Acute Kidney Injury admitted in ICU from the period of October 2018 to June 2020. Patients with chronic renal disease, previous renal transplantation, congenital renal disease were excluded from the study. RESULTS: Most of the patients (63%) were aged above 50 years. Diabetes was found in 55% and hypertension in 26% of AKI cases. Most common cause identied were sepsis, CLD, renal, CNS and CVD. Hypotension occurred in 48% patients, while oliguria occurred in 45% patients. Ventilatory support was required by 43% patients, while 31% patients required haemodialysis. Mortality rate in AKI was 51%. Mortality was signicantly associated with advanced age, presence of Diabetes, and RIFLE criteria. Spot urine <40 meq/L, hyperkalemia, serum creatinine >4 mg/dl, blood urea >100 mg/dl and acidosis were associated with higher mortality. CONCLUSION: Continuous monitoring parameters like Spot Fe Na, Serum Potasium and pH especially in patients at risk, like elderly patients with diabetes, those with sepsis, can help in early identication and appropiate management, thus reduce the incidence or severity of AKI.

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