Community-Acquired Acute Kidney Injury in a Tertiary Care Hospital: A Cross-sectional Study

Introduction: Acute kidney injury (AKI) is present in 1-5% of patients at hospital admission and it is reported that mortality rates range from 50% to 70% in these patients. The pathogenesis of AKI is complex and characterized by renal vasoconstriction and oxidative stress. Aim: The aim was to evaluate serum lactate dehydrogenase (LDH), uric acid (UA), amylase, and electrolyte levels in community acquired AKI patients and outcome of patients developing renal failure in the hospital. Materials and Methods: The present study is a cross-sectional study. A total of 160 participants were included and were grouped into 2 groups: Group-I included 100 patients admitted in emergency ward and Group-II included 60 normal healthy attendants accompanying the patients. Results: Mean blood urea levels in cases and controls were 87.71 +/- 42.65 and 29.7 +/- 3.15 mg/dL which was statistically significant (< 0.0001). When compared mean serum levels of creatinine (Cr), UA, LDH, amylase, calcium, phosphate, and potassium were 5.25 +/- 3.12 mg/dL, 18.42 +/- 4.43 mg/dL, 1362.54 +/- 502.04 IU/L, 262.83 +/- 132.61 IU/L, 7.6 +/- 1.4 mg/dL, 4.9 +/- 1.9 mg/dL and 5.4 +/- 0.5 mEq/L in Group-I (cases) while that of Group-II (controls) were 0.89 +/- 0.17 mg/dL, 4.22 +/- 1.12 mg/dL, 285.20 +/- 33.06 IU/L, 41.72 +/- 20.95 IU/L, 9.66 +/- 0.85 mg/dL, 3.44 +/- 0.47 mg/dL and 3.3 +/- 0.8 mEq/L and were statistically significant between the two groups (< 0.0001). 60% recovered fully and mortality rate among AKI patients was 22%. Conclusion: Study indicates that prompt recognition, aggressive management with intravenous hydration and careful monitoring of renal function, serum electrolytes, urine output, urinary UA, Cr, and there ratio to minimize nitrogenous waste production are essential for treating this condition. Study highlights the high morbidity and mortality of patients with community-acquired AKI, so it is recommended to have a close monitoring in these patients.