Author(s):
A. Sushmitha, P. Surpiya, CH. Krishna Vamsi, A. Rajani
Email(s):
adepurajani05@gmail.com
DOI:
10.5958/0974-360X.2020.00769.6
Address:
A. Sushmitha, P. Surpiya, CH. Krishna Vamsi, A. Rajani*
Department of Pharmacy Practice, MNR College of Pharmacy, Sangareddy, TS, India.
*Corresponding Author
Published In:
Volume - 13,
Issue - 9,
Year - 2020
ABSTRACT:
Aim and Objectives: The main aim and objective is to study the various causes and to understand the treatment and management of acute kidney injury in general population and critically ill patients and to have a thorough knowledge about acute kidney injury occurrence and its condition. Methodology: A hospital based prospective, observational, non-invasive study was carried out on all the inpatients attending the nephrology department, MNR Hospital for a period of 12 months. All the patients of either sex attending the nephrology department and patients admitted in critical care unit were included in the study. Patients of age 30 years and above with various causes involved in acute kidney injury are considered and patients are segregated accordingly. Patients with end stage renal disease and nephrology outpatient department is excluded in the study. Results: During the study period, total 157 cases of acute kidney injury have been recorded. Out of 157 cases 70 (44.58%) were male and 87(55.41%) were female patients and among these 12 fatal cases have been recorded. In this study highest percentage of AKI was recorded in the age group of 51-60 yrs (31.5%). Sepsis (42.1%) was the most common cause of AKI. In this study based on the aetiology of AKI, maximum incidence was seen in pre-renal cause having 136 (86.62%) patients. Maximum patients were non-oliguric. Out of 157 patients 94 (59.8%) required dialysis management, 51 (32.4%) patients were managed with conservative treatment. Conclusion: On the whole AKI is more common in critically ill patients who are in ICU. The majority of patients with AKI are in 51-60 years of age and most of them are managed with renal replacement therapy. Sepsis was found to be the most common cause of acute kidney injury. Through effective patient counselling clinical pharmacist can minimize the impact of drugs causing nephrotoxicity and improve the quality of life of patients with AKI. Early management is more beneficial for the patients to decrease the mortality rate.
Cite this article:
A. Sushmitha, P. Surpiya, CH. Krishna Vamsi, A. Rajani. Spectrum of Acute Kidney Injury and its Management in a Multispeciality Hospital Located at Hyderabad. Research J. Pharm. and Tech 2020; 13(9):4351-4356. doi: 10.5958/0974-360X.2020.00769.6
Cite(Electronic):
A. Sushmitha, P. Surpiya, CH. Krishna Vamsi, A. Rajani. Spectrum of Acute Kidney Injury and its Management in a Multispeciality Hospital Located at Hyderabad. Research J. Pharm. and Tech 2020; 13(9):4351-4356. doi: 10.5958/0974-360X.2020.00769.6 Available on: https://rjptonline.org/AbstractView.aspx?PID=2020-13-9-57
REFERENCES:
1. Nash K, Hafeez A, Hou. S, Hospital Acquired Renal Insufficiency, American Journal of Kidney Disease, May 2002, Vol. 39(5) : 930-936.
2. G.M Chertow et.al., Independent Association between acute renal failure and mortality following cardiac surgery, American Journal of Medicine, 1998, Vol. 104(4) : 343-348.
3. A. M. Escoresca Ortega, Z. Rus De Azua Lopez et.al., Kidney Failure after Heart Transplantation, Transplantation Proceedings, 2010, Vol. 42(8) : 3193-3195.
4. E.A.J Hoste, M. Schurgers et.al., Epidemiology of Acute Kidney Injury: How big is the problem?, Critical Care Medicine, 2008, Vol. 36(4) : 146-151.
5. G.M. Chertow, E. Burdick, et.al., Acute Kidney Injury, Mortality, Length of stay and costs in hospitalized patients, Journal of American Society of Nephrology, 2005, Vol.16(11) : 3365-3370.
6. C.M. Erley, B. D. Bader, et.al., Plasma Clearance of Iodine Contrast media as a measure of glomerular filtration rate in critically ill patients, Critical Care Medicine, 2001, Vol29(8) : 1544-1550.
7. H. Borsook, J.W. Dubnoff, The hydrolysis of phospho creatinine and the origin of urinary creatinine, The Journal of Biological Chemistry, 1947, Vol.168: 493-510.
8. M.C. Crim, D.H. Calloway, et.al., Creatinine metabolism in men: urinary creatinine and creatinine excretions with creatine feeding, Journal of Nutrition, 1975, Vol.105(4) : 428-438.
9. D.H. Calloway, S. Margen, et.al., Variation in endogenous nitrogen excretion and dietary nitrogen utilization as determinants of human protein requirement, Journal of Nutrition, 1971, Vol.101(2) : 205-26.
10. B.J. Hoogwerf, D.C. Laine et.al., Urine C-peptide and creatinine excreation in healthy young adults in varied diets: sustained effects of varied carbohydrate, protein and meat content, American Journal of Clinical Nutrition, 1986, Vol.43(3) : 350-360.
11. C. Hottelart, N.El. Esper, F.Ros et.al., Fenofibrate increases creatinemia by increasing metabolic production of creatinine, Nephron, 2002, Vol.92(3) : 536-541.
12. A.S. Levey, R.D. Perrone et.al., Serum Creatinine and renal function, Annual Review of Medicine, 1988, Vol. 39: 465-490.
13. S.M.Bagshaw, C. George et.al., A Comparison of RIFLE and AKIN criteria for Acute Kidney injury in critically ill patients, Nephrology Dialysis Transplantation, 2008, Vol. 23(5) : 1569-1574.
14. S.M. Bagshaw, C. George et.al., Early Acute Kidney injury and sepsis: a multicentre evaluation, Critical Care, 2008, Vol. 2(2) , article no. R.47.
15. W.Y. Kim , J.W. Huh et.al., A comparision of Acute Kidney Injury classifications in patients with severe sepsis and septic shock, The American Journal of Medical Sciences, 2012, Vol.44(5) : 350-356.
16. J.A. Lopes, S. Jorge et.al., Prognostic utility of RIFLE for Acute Renal failure in patients with sepsis, Critical Care, 2007, Vol.11, article no.408.
17. N. Lerolle, E. Guerot et.al., Reanl failure in septic shock: predictive value of Doppler- based renal arterial resistive index, Intensive Care Medicine, 2006, Vol. 32(10) : 1553-1559.
18. X. Valette, J.J. Parienti et.al., Incidence, morbidity and mortality of contrast induced acute kidney injury in a surgical intensive care unit: a prospective cohort study, Journal of Critical Care, 2012, Vol. 27(3) : 322.e1-322.e5.
19. S. Junior, E.D. F. Daher et.al., Risk factors for death among critically ill patients with acute renal failure, Sao Paulo Medical Journal, 2006, Vol. 124: 257-263.
20. A. Verma, V.K. Vanguri et.al., Acute kidney injury due to intravenous bleach injection, Journal of Medical Toxicology, 2012, Vol.9(1) : 1-4.
21. S.M. Bagshaw, S. Lapinsky, S. Dial et.al., Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy, Intensive Care Medicine, 2009, Vol.35(5) : 871-881.
22. M. Heung, L. S. Chawla et.al., Predicting progression to chronic kidney disease after recovery from acute kidney injury, Current Opinion in Nephrology and Hypertension, 2012, Vol.21(6) : 628-634.
23. M. Y. Rim, H. Ro, W.C. Kang et.al., The effect of rennin angiotensin aldosterone system blockade on contrast induced acute kidney injury- a propensity-matched study, Americam Journal of Kidney Diseases, 2012, Vol.60(4) : 576-582.
24. P.E. Drawz, R.T. miller et.al., Predicting hospital acquired acute kidney injury- a case control study, Renal failure, 2008, Vol. 30(9) : 848-855.
25. S. Uchino, J.A. Kellum et.al., Acute renal failure in critically ill patients: a multinational multi center study, Journal of American Medical Association, 2005, Vol.294(7) : 813-818.
26. J. C. D. V. Pontes, G.V. R. Silva et.al., Risk factors for development of acute renal failure following on-pump coronary artery bypass grafting, Brazilian Journal of Cardiovascular Surgery, 2007, Vol.22(4): 484-490.
27. B.S. Moffett and A. Cabrera et.al., Ketorolac-associated renal morbidity: risk factors in cardiac surgical infants, Cardiology in the Young, 2012, Vol.1: 1-3.
28. J.S.Rachoin, R. Daher, C.Moussallem et.al., The Fallacy of BUN: creatinine ratio in critically ill patients, Nephrology Dialysis Transplantation, 2012, Vol. 27: 2248-2254.
29. W.J.SQ. Santos, D.M.T. Zanetta, A.C. Pires et.al., Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit- a homogenous population?, Critical Care, 2006, Vol. 10(2): R68.
30. F. Liano, E. Junco, J. Pascual et.al., The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group, Kidney International, 1998, Vol. 66: S16-S24.
31. Elizabeth F Daher, Cristina N Marques et.al., Acute Kidney Injury in an infectious disease intensive care unit- an assessment of prognostic factors, Swiss Med Wkly, 2008, Vol. 138(9-10): 128-133
32. Brivet FG, Kleinknecht DJ, Loirat P et.al., Acute renal failure in intensive care units- causes, outcomes and prognostic factors of hospital mortality- a prospective mutlicenter study, French study group on acute renal failure, Critical Care Medicine, 1996, Vol. 24: 192-198.