ASSESSMENT OF CAUSES OF INTENSIVE CARE UNIT ADMISSIONS IN RENAL DISEASE PATIENTS: A CROSS-SECTIONAL STUDY

MZ SIKANDAR; MAW KHAN; AA KHAN; M JAVED; SMH MOEEN; A ASGHAR

doi:10.54112/bcsrj.v2023i1.612

Authors

MZ SIKANDAR Department of Nephrology, Central Park Medical College, Lahore, Pakistan
MAW KHAN Department of Nephrology, Choudhary Muhammad Akram Teaching Hospital, Lahore, Pakistan
AA KHAN Department of Nephrology, Azra Naheed Medical College, Chaudhry Muhammad Akram Teaching Hospital, Superior University, Lahore, Pakistan.
M JAVED Department of Nephrology, Sheikh Zaid Hospital Lahore, Pakistan
SMH MOEEN Department of Nephrology, Azra Naheed Medical College, Chaudhry Muhammad Akram Teaching Hospital, Superior University, Lahore, Pakistan.
A ASGHAR Department of Nephrology, Azra Naheed Medical College, Chaudhry Muhammad Akram Teaching Hospital, Superior University, Lahore, Pakistan.

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.612

Keywords:

ESRD End Stage Renal Disease, MHD Maintenance Hemodialysis, RRT Renal Replacement Therapy, AKI Acute Kidney Injury

Abstract

The incidence of End-Stage Renal Disease (ESRD) is on the rise, making it a significant group of patients requiring admission to critical care units. At the same time, the field of Acute Kidney Injury (AKI) has flourished, leading to an increased number of patients with kidney dysfunction in critical care units. Our objective is to assess the causes of admission of patients with kidney disease in a large tertiary care hospital, the Medical Intensive Care Unit (MICU). This is a retrospective electronic case notes study. We collected data from the electronic records of all patients admitted to the MICU with renal problems from 1/7/2022 until 1/10/2022. The data was later analyzed in Microsoft Excel. During the study period, 503 patients were admitted to the MICU, of which 160 (31.8%) had renal disease. The median age was 50 years, ranging from 17 to 92 years. Females accounted for 42.5% of patients, while males accounted for 48.5%. Of the 160 patients, 97 (60.5%) were known to have ESRD, while 63 (39.5%) had AKI due to systemic illness. Fluid overload (40/55, 76.3%), followed by uremic encephalopathy (15/55, 27.2%) and hyperkalemia (12/55, 21.8%), remained the most common causes for initiation of Renal Replacement Therapy (RRT) in 55/97 (56.7%) ESRD patients. The mortality rate was 23.7% (38/160) in renal patients in the medical ICU. Our study highlights the increasing number of patients with kidney disease requiring admission to a medical ICU and their high mortality rate. Sepsis remains the leading cause of admission for ESRD patients on Maintenance Hemodialysis (MHD). At the same time, fluid overload was found to be the primary cause of starting RRT in advanced kidney disease.

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