DOI: https://doi.org/10.36347/sasjm.2026.v12i06.007

Pages: 610-620

Background: Acute kidney injury (AKI) is a frequent and severe complication in intensive care units, associated with high morbidity and mortality. Its management often requires renal replacement therapy (RRT). Objectives: To describe the epidemiological profile of patients requiring RRT, the indications and modalities of dialysis, as well as the risk factors associated with mortality and non-recovery of renal function. Methods: We conducted a retrospective, descriptive, and analytical study including 594 patients who underwent urgent RRT in several intensive care units in Rabat between January 2022 and December 2024. Demographic, clinical, biological, therapeutic, and outcome data were collected and analyzed using JAMOVI software. AKI was defined according to the 2012 KDIGO guidelines. Results: The mean age was 43 ± 10.7 years, with a male predominance (61%). The most frequent comorbidities were hypertension (40.1%), diabetes mellitus (29.6%), and ischemic heart disease (20%). The main indications for RRT were oligo-anuria associated with acute pulmonary edema (63%), severe metabolic acidosis (57%), life-threatening hyperkalemia (36%), and severe uremia (40%). In-hospital mortality was 44.6%. Independent predictors of mortality included age >60 years, septic shock, invasive mechanical ventilation, and severe anemia. Complete recovery of renal function was observed in 60% of patients. Factors associated with non-recovery of renal function included hypertension, diabetes mellitus, ischemic heart disease, oligo-anuria, septic shock, hyperkalemia, and severe metabolic acidosis. Conclusion: AKI in critically ill patients remains frequent, complex, and associated with high mortality. Prompt and appropriate management may allow renal recovery in a substantial proportion of patients. Identification of risk factors for mortality and non-recovery of renal function is essential to guide therapeutic strategies and improve patient outcomes.