Outcomes and Risk Factors in Acute Renal Failure: A Cross-Sectional Study of Hospital and Community-Acquired Cases
DOI:
https://doi.org/10.69980/ajpr.v28i5.609Keywords:
Acute Kidney Injury, Mortality, Dialysis, Community-acquired AKI, Hospital-acquired AKI, Risk Factors, Nephrotoxic Drugs, Diabetes, AKI StageAbstract
Introduction
Acute kidney injury (AKI) is a common and severe condition associated with high morbidity and mortality. The aim of this study was to compare the incidence, etiological factors and clinical outcomes between community-acquired (CA-ARF) and hospital-acquired (HA-ARF) acute renal failure in a tertiary care setting. These results will aid in identifying factors that may be targeted for improved clinical intervention and comprehensive patient management.
Methodology
A cross-sectional observational study done in a government medical college of North Maharashtra in 162 hospitalized patients diagnosed as having AKI. The patients were classified into two groups consequently as CA-ARF and HA-ARF depending on the emergence status of AKI. This included data collected retrospectively from patient charts, including demographic details, comorbidities, AKI stage, laboratory results and clinical outcomes. Univariate, multivariate logistic regression analysis was used for identifying the independent predictors of poor outcomes like mortality and dialysis requirement.
Results
The majority (67.3%) of the study participants had Stage 1 AKI, while fewer were found to have Stage 2 (22.2%) and Stage 3 AKI (10.5%). Community-acquired AKI occurred in most patients (71.6%), while 28.4% with hospital-acquired AKI Independent predictors of poor outcomes were advanced age, diabetes, episodes in the AKI stage and nephrotoxic drug use. Results: Overall 28-day mortality was 94% in patients developing Stage-3 AKI and diabetes was associated with higher odds of Bad outcome (OR=2.15). Creatinine levels at admission and hospital-acquired AKI were significant risk factors in the logistic regression.
Conclusion
This study underscores the importance of AKI stage, diabetes, age, and nephrotoxic drug use as key predictors of poor outcomes in AKI patients. The findings emphasize the need for early diagnosis and timely management, particularly in high-risk populations. Effective monitoring and interventions, especially in patients with comorbidities such as diabetes, can significantly improve survival rates and reduce the need for renal replacement therapy.
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