Iram Hina, Ali Muhammad, Kumar Vinod, Ejaz Ayesha, Solangi Shafique A, Junejo Abdul Manan, Solangi Sagheer Ahmed, Un Nisa Noor
Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Department of Nephrology, Fazaia Ruth Pfau Medical College, Karachi, PAK.
Cureus. 2020 Dec 9;12(12):e12001. doi: 10.7759/cureus.12001.
To determine the frequencies of risk factors and the ultimate outcomes of ccute kidney injury (AKI) among hospitalized patients.
This prospective, observational study was carried out from September 15, 2018, to March 14, 2019. All admitted patients, both male and female, with AKI, were included. Those with chronic kidney disease (CKD), small size echogenic kidneys (on ultrasonography, performed on admission), and recent history of urological intervention were excluded from the study. All patients were assessed for etiological factors (sepsis, gastroenteritis, surgical, and obstetrical) and outcome (improved, progression to CKD, or expired).
Out of a total of 230, most patients were aged between 20-50 years with a mean age of 38.99 ± 7.61 years. Males were 144 (62.61%) and females were 86 (37.39%). About 78 (33.91%) patients were hypertensive while 65 (28.26%) were diabetic. The cause of hospital-acquired AKI was found to be sepsis in most (71.73%, n=165) of the cases, followed by gastroenteritis (10.00%, n=23), surgical (9.56%, n=22), and obstetric (8.69%, n=20) causes. When the outcome was assessed, 10 (4.35%) patients expired, 154 (66.96%) improved completely, while 66 (28.69%) progressed to CKD.
This study has shown that sepsis is the most common cause of AKI in patients admitted to the hospital. So we recommend that proper steps should be taken to ensure adequate hospital care for avoiding such outcomes in hospitalized patients, and further decrease mortality.
确定住院患者急性肾损伤（AKI）的危险因素频率及最终结局。
本前瞻性观察性研究于2018年9月15日至2019年3月14日进行。纳入所有确诊为AKI的住院患者，男女不限。排除患有慢性肾脏病（CKD）、入院时超声检查显示肾实质回声增强的小肾脏以及近期有泌尿外科干预史的患者。对所有患者评估病因（脓毒症、肠胃炎、手术及产科相关）及结局（病情改善、进展为CKD或死亡）。
在总共230例患者中，大多数患者年龄在20至50岁之间，平均年龄为38.99±7.61岁。男性144例（62.61%），女性86例（37.39%）。约78例（33.91%）患者患有高血压，65例（28.26%）患者患有糖尿病。医院获得性AKI的病因在大多数病例（71.73%，n = 165）中为脓毒症。其次是肠胃炎（10.00%，n = 23）、手术（9.56%，n = 22）及产科相关（8.69%，n = 20）病因。评估结局时，10例（4.35%）患者死亡，154例（66.96%）患者完全康复，而66例（28.69%）进展为CKD。
本研究表明，脓毒症是入院患者AKI最常见的病因。因此，我们建议应采取适当措施，确保为住院患者提供充分的医疗护理，以避免此类结局并进一步降低死亡率。
