Haridas Nived, Thirumavalavan S, Fernando M Edwin, Vellaisamy Murugesan, Annadurai Poongodi, Srinivasaprasad N D, Surendran Sujit, Valavan K Thirumal, Joseph Jerry, Gayathri M S
Department of Nephrology, Stanley Medical College and Hospital, Chennai, Tamil Nadu, India.
Department of Clinical Immunology, JIPMER Puducherry, India.
Indian J Nephrol. 2024 Jul-Aug;34(4):338-343. doi: 10.25259/ijn_285_23. Epub 2024 Jun 10.
Acute kidney injury (AKI) is a severe complication of acute diarrheal diseases; however, there is limited data on post-diarrheal AKI (PD-AKI) epidemiology and outcomes. This study aimed to investigate the clinicodemographic profile and outcomes of PD-AKI in our hospital.
We retrospectively analyzed data from 93 patients admitted with PD-AKI during a diarrheal illness epidemic. Patients were stratified based on the Kidney Disease: Improving Global Outcomes (KDIGO) AKI stage and quick Sequential Organ Failure Assessment (qSOFA) score. Clinicodemographic data and outcomes were recorded and analyzed.
The mean age of the patients was 45.7 ± 11.9 years, with a majority being men (n = 55, 59%). All patients presented with watery diarrhea, 85% (n = 79) had vomiting, and 66% (n = 61) presented in shock. At presentation, 59% were oliguric, while 32% were anuric. KDIGO stage 3 AKI was observed in 71% (n = 66) of patients. Dialytic support was required in 29% (n = 27) of cases. The mortality rate was 6.5% (n = 6), mostly due to refractory shock, while the remaining patients recovered. Risk factor analysis demonstrated a higher qSOFA score, and peak serum creatinine levels were associated with an increased likelihood of requiring renal replacement therapy and delayed renal recovery.
This study provides valuable insights into the clinicodemographic characteristics and outcomes of PD-AKI. The high prevalence of severe AKI emphasizes the importance of early recognition and appropriate management strategies for these patients.
急性肾损伤(AKI)是急性腹泻病的一种严重并发症;然而,关于腹泻后急性肾损伤(PD-AKI)的流行病学和结局的数据有限。本研究旨在调查我院PD-AKI的临床人口统计学特征和结局。
我们回顾性分析了在腹泻病流行期间因PD-AKI入院的93例患者的数据。根据肾脏病:改善全球预后(KDIGO)AKI分期和快速序贯器官衰竭评估(qSOFA)评分对患者进行分层。记录并分析临床人口统计学数据和结局。
患者的平均年龄为45.7±11.9岁,大多数为男性(n = 55,59%)。所有患者均出现水样腹泻,85%(n = 79)有呕吐,66%(n = 61)出现休克。就诊时,59%的患者少尿,32%的患者无尿。71%(n = 66)的患者观察到KDIGO 3期AKI。29%(n = 27)的病例需要透析支持。死亡率为6.5%(n = 6),主要原因是难治性休克,其余患者康复。危险因素分析表明,较高的qSOFA评分和血清肌酐峰值水平与需要肾脏替代治疗和肾脏恢复延迟的可能性增加相关。
本研究为PD-AKI的临床人口统计学特征和结局提供了有价值的见解。严重AKI的高患病率强调了对这些患者进行早期识别和适当管理策略的重要性。