Original Research

Predisposing Factors in Acute Kidney Injury Patients Leading to Hemodialysis

DOI https://doi.org/10.70302/jpsim.v4i4.2358
Received: 16 Aug 2023 Accepted: 11 Aug 2023 Published Online: 29 Nov 2023

Abstract

Objective

To identify the risk variables of AKI patients needing hemodialysis in a tertiary care hospital in Pakistan.

Methods

A retrospective study of 1100 patients included in the research between January 2017 and Decem-ber 2018 at Aga Khan University Hospital, of which 347 met the inclusion criteria.

Results

According to the study, sepsis - which affects 30% of patients - emerged as the most important risk factor for needing dialysis. Dialysis was necessary for 0.7% of patients with stage 1 AKI, 7.7% of patients with stage 2 AKI, and 14.2% of patients with stage 3 AKI.

Conclusion

According to the study, sepsis is a key risk factor for AKI requiring hemodialysis, even in cases with less severe form of AKI. These results assist in patient management and follow-up as they highlight the common risk factors that could lead to short and long- term morbidity and mortality of AKI patients. The study also implies that these results might guide focused therapy actions to improve patient outcomes.

Keywords
Acute Kidney Injury Renal Dialysis Hemodialysis Glomerular Function Tests Nephrotoxic Agents Chronic Kidney Disease

How to Cite This Article

Saleem M, Butt A, Ayaz A, Iqbal B, Raza H, Saifuddin A, et al.. Predisposing Factors in Acute Kidney Injury Patients Leading to Hemodialysis. J Pak Soc Intern Med. 2023;4(4):289–292. doi:10.70302/jpsim.v4i4.2358

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Wijayaratne D, Beligaswatta C, Harber M. Acute Kidney Injury Epidemiology and Causes. In: Primer on Nephrology. Cham: Springer International Publishing; 2022. p. 153–80.
  2. Hoste EAJ, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol. 2018;14(10):607–25.
  3. Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, et al. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol. 2013;8(9):1482–93.
  4. Ronco C, Bellomo R, Kellum JA. Acute kidney injury. Lancet. 2019;394(10212):1949–64.
  5. Mehta RL, Cerdá J, Burdmann EA, Tonelli M, García-García G, Jha V, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015;385(9987):2616–43.
  6. Thongprayoon C, Hansrivijit P, Kovvuru K, Kanduri SR, Torres-Ortiz A, Acharya P, et al. Diagnos-tics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm. J Clin Med. 2020;9(4):1104.
  7. Abdel-Rahman EM, Turgut F, Gautam JK, Gautam SC. Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond. J Clin Med. 2021;10(6):1175.
  8. Ahmad S, Anees M, Elahi I, Fazal-E-Mateen. Rhabdomyolysis Leading to Acute Kidney Injury. J Coll Physicians Surg Pak. 2021;31(2):235-7.
  9. Ali A, Khan MNA, Ali I, Hussain MZ, Khan MS, Sajid Y. Aetiology and Outcome of Acute Kidney Injury Patients at the Nephrology Unit of Pak Emirats Military Hospital Rawalpindi. Pak Armed Forces Med J 2022; 72(6): 2025-8.
  10. Melo F de AF, Macedo E, Fonseca Bezerra AC, Melo WAL de, Mehta RL, Burdmann E de A, et al. A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and de-veloping countries. PLoS One. 2020;15(1): e0226325.
  11. Anandh, U., Noorin, A., Kazmi, S.K.S. et al. Acute kidney injury in critically ill COVID-19 infected pa-tients requiring dialysis: experience from India and Pakistan. BMC Nephrol. 2022; 23(1), 308.
  12. Sonia Yaqub, Amna Hamid, Marwah Saeed, Safia Awan, MO310: Clinical Characteristics and Out-comes of Acute Kidney Injury in Hospitalized Patients With COVID-19: Experience at a Major Tertiary Care Center in Pakistan. Nephrology Dialysis Transplantation. 2022;37(3):e068020.
  13. Naqvi R. Epidemiological trends in community acquired acute Kidney Injury in Pakistan: 25 years' Expe-rience from a Tertiary Care Renal Unit. Pak J Med Sci. 2021;37(2):312-319.
  14. Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL. Notice. Kidney Int Suppl. 2012;2(1):1.
  15. Cockcroft DW, Gault H. Prediction of Creatinine Clearance from Serum Creatinine. Nephron. 1976;16(1):31–41.
  16. do Nascimento GVR, Gabriel DP, Abrão JMG, Balbi AL. When is dialysis indicated in acute kidney injury? Ren Fail. 2010;32(3):396–400.
  17. Hsu CY, Ordoñez JD, Chertow GM, Fan D, McCulloch CE, Go AS. The risk of acute renal failure in patients with chronic kidney disease. Kidney Int. 2008;74(1):101–7.
  18. Kamaruddin M, Hamid SAA, Adnan AS, Naing NN, Wan Adnan WNA. Associated factors of dialysis-dependence among acute kidney injury patients in intensive care unit. Saudi J Kidney Dis Transpl. 2019;30(5):1131–6.
  19. Garnier F, Couchoud C, Landais P, Moranne O. Increased incidence of acute kidney injury requiring dialysis in metropolitan France. PLoS One. 2019;14(2): e0211541.
  20. Hsu RK, McCulloch CE, Dudley RA, Lo LJ, Hsu C yuan. Temporal Changes in Incidence of Dialysis-Requiring AKI. Journal of the American Society of Nephrology. 2013;24(1):37–42.
  21. Hameed M, Carmichael P. Aetiology and outcomes for dialysis-dependent acute kidney injury pa-tients on the ICU. Crit Care. 2013;17(S2): P428.
  22. Fortrie G, de Geus H.R.H, Betjes M.G.H. The aftermath of acute kidney injury: a narrative review of long-term mortality and renal function. Crit Care. 2019; 23(2): 24.

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CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2023 Journal of Pakistan Society of Internal Medicine.