INCIDENCE OF ACUTE KIDNEY INJURY IN PATIENTS OF ACUTE GASTROENTERITIS ADMITTED AT LADY READING HOSPITAL, PESHAWAR
Keywords:AKI, Acute kidney injury, Acute gastroenteritis, hemodialysis.
Acute gastroenteritis affects all age groups alike, is a common cause of hospitalization worldwide, and is the most common known cause of preventable acute kidney injury. AKI may be defined as a sudden decrease in kidney function, which results in reduced filtration capability of the kidneys, accumulation of waste products, and their resultant clinical manifestations. The level of insult may range from mild to severe, requiring simple oral rehydration most times, while in a few cases needing intervention in the form of hemodialysis. The elderly population is more prone to develop AKI due to age-related deterioration in renal function. An overall positive outcome has been associated with early hemodialysis in progressively deteriorating AKI and critically ill patients. A prospective observational study was conducted on 40 patients with AKI secondary to acute gastroenteritis admitted to MTI, Lady Reading Hospital, Peshawar, KP, Pakistan, from February 2023 to June 2023. These patients were selected from 142 patients with acute gastroenteritis admitted to MTI, Lady Reading Hospital, Peshawar. Data collected was analyzed using SPSS 20. This study was conducted on 40 patients with a mean age of 39.82±16.54 years. Gender: Our study included 22 (55%) male and 18 (45%) female patients. We observed that 11 (27.5%) patients on dialysis had developed AKI secondary to AGE. We observed that older patients above 40 years of age who developed AKI secondary to AGE had a significantly higher frequency of hemodialysis (47.1%) as compared to patients less than 40 years of age (13%) (P = 0.01). According to the comparison of mortality with age groups, no mortality was seen in the age group of < = 40 years; however, there were 2 mortalities in the age group of > 40 years. One patient expired after 2 sessions, and one expired after 5 sessions and a prolonged stay. Our results showed a significant association between favorable outcomes and dialysis sessions for the less than 40 age group (P = 0.0001) and the more than 40 age group (P = 0.004). Although the overall outcome with dialysis was favorable, with good recovery, the age group of 40 years and above showed significantly higher rates of hemodialysis requirement and more morbidity and mortality compared to the age group of 40 years and less. 40(28.2%) patients with Acute gastroenteritis developed Acute kidney injury. Among these patients, 11 (27.5%) required hemodialysis. This concluded that 29 patients (72.5%) were treated conservatively and discharged with full recovery of renal function. 72.7% requiring hemodialysis were above 40 years of age, proving that the incidence of AKI and its severity increased.
Bányai, K., Estes, M. K., Martella, V., and Parashar, U. D. (2018). Viral gastroenteritis. The Lancet 392, 175-186.
Bhakthavatchalam, S., Srinivasan, D., and Prithviraj, R. (2021). The requirement of hemodialysis in patients with acute gastroenteritis–induced acute kidney injury. Journal of Family Medicine and Primary Care 10, 2423.
Bogari, M. H., Munshi, A., Almuntashiri, S., Bogari, A., Abdullah, A. S., Albadri, M., Hashim, A., and AlZahrani, M. S. (2023). Acute gastroenteritis-related acute kidney injury in a tertiary care center. Annals of Saudi Medicine 43, 82-89.
Bradshaw, C., Zheng, Y., Silver, S. A., Chertow, G. M., Long, J., and Anand, S. (2018). Acute kidney injury due to diarrheal illness requiring hospitalization: data from the National Inpatient Sample. Journal of General Internal Medicine 33, 1520-1527.
Coca, S. G. (2010). Acute kidney injury in elderly persons. American Journal of Kidney Diseases 56, 122-131.
Ishani, A., Xue, J. L., Himmelfarb, J., Eggers, P. W., Kimmel, P. L., Molitoris, B. A., and Collins, A. J. (2009). Acute kidney injury increases risk of ESRD among elderly. Journal of the American Society of Nephrology: JASN 20, 223.
Jamal, N., Banaras, F., Ashfaq, M., Tahir, T., Jadoon, I., and Raza, A. (2022). Incidence of Acute Kidney Injury (AKI) Secondary to Acute Gastroenteritis in Patients Presenting to Ayub Teaching Hospital, Abbottabad. Pakistan Journal of Medical & Health Sciences 16, 537-537.
Lee, C.-C., Kuo, G., Chan, M.-J., Fan, P.-C., Chen, J.-J., Yen, C.-L., Tsai, T.-Y., Chen, Y.-C., Tian, Y.-C., and Chang, C.-H. (2023). Characteristics of and outcomes after dialysis-treated acute kidney injury, 2009-2018: a Taiwanese Multicenter study. American Journal of Kidney Diseases 81, 665-674. e1.
Mostafi, M., Nessa, M. A., Fakir, M. A. H., Bhuiyan, M. A. Q., and Rahman, A. M. (2011). Presentation and outcome of acute kidney injury in a tertiary military hospital of Bangladesh. Bangladesh Journal of Medicine 22, 35-40.
Schiffl, H., Lang, S. M., and Fischer, R. (2002). Daily hemodialysis and the outcome of acute renal failure. New England Journal of Medicine 346, 305-310.
Silveira Santos, C. G. d., Romani, R. F., Benvenutti, R., Ribas Zahdi, J. O., Riella, M. C., and Mazza do Nascimento, M. (2018). Acute kidney injury in elderly population: a prospective observational study. Nephron 138, 104-112.
Yokota, L. G., Sampaio, B. M., Rocha, E. P., Balbi, A. L., Sousa Prado, I. R., and Ponce, D. (2018). Acute kidney injury in elderly patients: narrative review on incidence, risk factors, and mortality. International journal of nephrology and renovascular disease, 217-224.
How to Cite
Copyright (c) 2023 FS HAYAT , Z IKHTIAR , I BADSHAH , M HUSSAIN , M HADI , I KHAN , H IKHTIAR , A KHAN
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.