DOI: https://doi.org/10.36347/sasjm.2026.v12i09.002

Pages: 861-868

Background: The development of DI-AKI is influenced by patient characteristics and the underlying condition of the kidneys, in addition to exposure to nephrotoxic medications. Therefore, this study aimed to determine the incidence, risk factors, clinical outcomes, and economic burden of drug-induced acute kidney injury among hospitalized patients. Methods: This prospective observational study was conducted in the Departments of Nephrology and Medicine, Mugda Medical College Hospital, Dhaka, Bangladesh, from January 2026 to June 2026, among 246 hospitalized patients. Demographic, clinical, medication, renal outcome, and cost data were collected and analyzed using SPSS. Drug-induced AKI, risk factors, clinical outcomes, and economic burden were assessed using the chi-square test, with p<0.05 considered significant. Results: Among 246 hospitalized patients, D-AKI occurred in 62 (25.2%), with Stage 1 being the most common severity category (50.0%). Complete renal recovery was achieved in 77.4% of patients, while 11.3% required renal replacement therapy and 9.7% died. Antibiotics were the most frequently implicated drug class (40.3%), followed by diuretics (29.0%) and ACE inhibitors/ARBs (24.2%). Older age, hypertension, diabetes mellitus, chronic kidney disease, sepsis/infection, polypharmacy, and exposure to NSAIDs, diuretics, and ACE inhibitors/ARBs were significantly associated with D-AKI (p<0.05). Patients with D-AKI had a significantly longer mean hospital stay than those without D-AKI (14.2 ± 6.8 vs. 8.1 ± 4.2 days; p<0.001) and significantly higher mean total hospitalization costs (BDT 24,450 ± 8,920 vs. BDT 16,820 ± 6,240; p<0.001). Conclusion: Drug-induced AKI is a significant and potentially preventable complication associated with multiple risk factors, prolonged hospitalization, and increased healthcare costs, underscoring the need for rational prescribing and early renal monitoring.