Epidemiology and Outcome of Acute Kidney Injury in Critical Care Unit: A Prospective Observational Study

Background Acute kidney injury (AKI), an important and challenging problem in critical care units (CCUs), remains relatively underexplored in developing countries. This study was conducted to understand the spectrum, outcomes, and prognostic factors of AKI in CCU. Materials and Methods A single-center prospective observational study, conducted from February 2023 to July 2024, included adult patients admitted to CCU with AKI. Data were recorded on days 0, 3, 7, 30, and 180. Outcome assessed included both short-(in-hospital mortality) and long-term (renal recovery at 6 months). Results AKI incidence was 35.0% (n=350), and the mean age was 45.1 years. The population was 60% male, and the mean CCU stay was 15.3 days. The prevalent AKI patterns were hospital-acquired (HA-AKI) (50.9%), stage 3 (38.0%), and sepsis-related (61.71%), and 72% required dialysis. In-hospital mortality was 42.0%; complete recovery and no recovery at 6 months were 34.3% and 38.9%, respectively. Both short- and long-term outcomes were influenced by demographic factors like age, sex; clinical parameters like hypotension, oliguria, positive fluid overload; disease related factors like AKI subtype, severity, and etiology; laboratory parameters like increased inflammatory markers, low serum albumin; and treatment related factors like drugs, specific intravenous fluid and inotrope, dialysis support and mechanical ventilator requirement. Conclusion AKI in CCU is common, mostly sepsis-related, and frequently severe. AKI in CCU has high in-hospital mortality and poor long-term renal outcomes.