Abstract: FR-PO051
A Study of Severe Tropical AKI Requiring Renal Replacement Therapy in a Tertiary Care Hospital in South India
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Kolla, Praveen Kumar, Narayana Medical College, Nellore, India
Background
The etiology of tropical AKI can be divided into infections, toxins, poisons and miscellaneous causes like heat stroke and obstetric AKI etc. Acute tubular injury occurring secondary to community acquired infections remains the commonest cause of tropical AKI. Through this study we attempt to study the causes and factors associated with morbidity and mortality of severe AKI requiring RRT in south India
Methods
This is a retrospective observational study done in Narayana Medical College, Nellore. Patients admitted in the ICU with AKI within a period of 3 years (2016-2018) were screened. Patients with non-tropical causes of AKI and AKI not requiring RRT were excluded from the study. The baseline eGFR was calculated according to the MDRD 75 formula. All patients eGFR was calculated 3 months after discharge to look for recovery or classify as CKD. Complete recovery was defined as improvement in the eGFR to more than the calculated baseline eGFR, at the end of 3 months after discharge. Descriptive analysis and univariate regression analysis were done to find factors associated with recovery, progression to CKD and death
Results
A total of 130 patients were studied with the mean age of presentation being 42.7 years and 62.3% (n=81) of the patients were males. The mean duration of stay in the hospital was 12.35 days. 8.4 % (n=11) patients received peritoneal dialysis and 91.5 % (n=119) received hemodialysis (HD). The most common etiology of AKI was acute gastroenteritis (40.7%) followed by snake bite (15.3%), hair dye poisoning (11.5%), malaria (9.2%), obstetric AKI (6.9%), dengue (5.3%), leptospirosis (3.8%), scrub typhus (3.0%), rhabdomyolysis (1.5%), paraquat poisoning (0.7%) and petroleum product consumption (0.7%). 96.9% patients presented with KDIGO stage 3 of AKI with average eGFR of 9.72. The average eGFR after 3 months of discharge was 40.93. Out of 130 patients 18.4% recovered completely, 14.6% (n=19) expired and 66.92% progressed to CKD. Snake bite, dengue fever, thrombocytopenia, presence of diabetes mellitus, hypertension and coronary artery disease were independently associated with progression towards to CKD. Paraquat poisoning and petroleum product ingestion were independently associated with death
Conclusion
Severe tropical AKI requiring RRT holds a poor prognosis with majority of patients progressing to CKD