Abstract
Background:
Acute Kidney Injury is not a single disease but rather a syndrome comprising of multiple clinical conditions. The high rate of morbidity associated with AKI poses a burden on both the public as well as private sector. Small changes in serum creatinine concentrations associated with a substantial increase in the risk of morbidity. Therefore, detection of even small changes in kidney injury has an important prognostic value to avoid chances of hemo-dialysis and the associated risks which can result in both better outcomes as well as lowering financial burden on the patient as well as the state.
Methods:
A sample size of 100 patients was included as calculated by taking reported incidence of 36%. Patient’s baseline and maximum creatinine was taken during ICU stay together with urine output monitoring during first 48 hours. Staging of acute kidney injury (AKI) was done by Acute Kidney Injury Network (AKIN) criteria. Outcome of renal failure was assessed on the basis of full, partial and no recovery.
Results:
Out of 100 patients, 52% were in stage 1, 32% were in stage 2 and 16% were in stage 3. AKI was common in females; present in 37 males and 63 females; (p value <0.05). Full renal recovery was achieved in 62 patients (62%) of AKI; 25 patients (25%) were partial recovered, and in 13 patients (13%) recovery could not be achieved. Recovery was significantly lower (25%) and potentially greater in stage1 (79%).The chi square between outcome and acute kidney injury revealed statistical significant value (p value <0.001). Hemodialysis requirement was significantly higher in AKI stage3 (62%) than AKI stage1 (4%); (P < 0.001). There were no significant differences in duration of ICU stay, age and mortality.
Conclusion:
Our study showed the morbidity and mortality associated with rising creatinine with increasing stages of acute kidney injury. Recovery in stage 1 was significantly higher and lower in stage 3 and therefore emphasis is required on early diagnosis and timely management of AKI that can prevent patients from distressing and life threatening problems.
Quratulain Khan, Ejaz Vohra. (2016) Outcomes Of Various Stages Of Acute Kidney Injury In Critical Care Patients, The Pakistan Journal of Medicine and Dentistry, Volume-5, Issue-2.
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