DOI: 10.36347/sjams.2020.v08i10.040

Pages: 2426-2430

Acute kidney injury (AKI) which is defined as an abrupt decline in renal function in a short period of time may be hospital-acquired AKI (HAAKI) or community-acquired AKI (CAAKI). This prospective study was conducted from October 2017 to September 2019 to compare the various clinical profile of patients with CAAKI and HAAKI. Patients with CAAKI and HAAKI aged 18 years and above were included in the study and patients with pre-existing renal disease, acute-on-chronic kidney disease and renal dysfunction in pregnancy were excluded. CAAKI was defined as those patients who were admitted with AKI whereas HAAKI as those who developed AKI after 48 hours of hospitalisation. Incidence of CAAKI and HAAKI was 1.07% and 0.44% respectively. There was no significant difference in the mean age and gender among the groups. Among the primary disease at admission, trauma and wound related diseases were significantly higher in HAAKI (<0.001) whereas neurological diseases was higher in CAAKI (<0.01). Sepsis (27.7%) and drug induced AKI (31.8%) was the most common cause of AKI in CAAKI and HAAKI respectively. In both the groups maximum number of the patients were in RIFLE–I category and more than 50% of the case was due to acute tubular necrosis (p< 0.7). HAAKI patients required renal replacement therapy (RRT) more frequently (p<0.01), needed longer hospital stay and had higher mortality (31.8%) (p< 0.002) in comparison with CAAKI. Our data suggests that CAAKI and HAAKI are a common cause of AKI. Development of HAAKI has a worse prognosis in disease outcome.