A prospective study of aetiology and outcome of acute kidney injury in type 2 diabetes patients

Abstract

Introduction: Acute kidney injury (AKI) describes the clinical syndrome earlier called acute renal failure. AKI is defined as structural or functional abnormality of the kidney that manifests within 48 h, as determined by blood, urine, tissue tests or by imaging studies. AKI is depicted by rapid (over hours to days) decline in glomerular filtration rate, retention of nitrogenous waste products and perturbation of the extra-cellular fluid volume, electrolytes and acid-base homeostasis. AKI constitutes approximately 5% of hospital admissions and up to 30% of admissions to intensive care units (ICU). Materials and Methods: A prospective study was conducted at Department of Internal Medicine, KIMS Hospital, Ongole from January 2021 to December 2021 (1 year). Type 2 diabetic patients 30 years or above, irrespective of gender, diagnosed to have acute kidney injury using KDIGO criteria, admitted to ICU or wards under the Department of Internal Medicine, KIMS Hospital, Ongole were included in the study. Patients with preexisting renal disease and those who received renal transplantation were excluded from the study. Type 2 diabetic patients admitted in the ICU and wards under Medicine and Nephrology department, KIMS Hospital, Ongole were evaluated in detail after taking prior consent. Evaluation includes detailed history taking and physical examination. Acute kidney injury will be assessed on the basis of their serum creatinine and/or urine output fulfilling the KDIGO criteria. Results: The study was conducted in a total of 150 diabetic patients who developed acute kidney injury. There were 94 males and 56 females. The aetiology and outcome of acute kidney injury in the above patients were found out. Blood urea, serum creatinine, serum electrolytes, fasting and post-prandial blood sugar, WBC count, platelet count and haemoglobin were included as the baseline parameters. Conclusion: Infection was the most common cause of AKI in Type 2 diabetes patients in our study. Among drug induced renal failure patients, NSAIDS were noted to be most common cause. Age >60 and male gender were prevalent in the majority of AKI patients. About 52.66% of the total patients recovered to normal renal function, 13.3% recovered partially, with 14% of the total patients progressed for maintenance hemodialysis. Crude mortality rate among patients with AKI in the study group was 20%.