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Article Abstract
Background: Acute kidney injury (AKI) represents one of the most challenging and common complications encountered in critically ill patients admitted to intensive care units (ICUs) worldwide. This sudden deterioration in kidney function substantially contributes to morbidity and mortality in the intensive care setting, prolongs hospital stays, and increases healthcare costs.
Objective: The objective of this study is to study the clinical profile, etiology, complications, and outcomes of AKI in critically ill patients admitted to the medicine ICU.
Methodology: This prospective observational cross-sectional study was conducted at Dr. D. Y. Patil Medical College and Research Centre, Pimpri, Pune, between March 2023 and December 2024. A total of 150 patients with AKI admitted to the medicine ICU were included after obtaining written informed consent. AKI was defined according to the Kidney Disease: Improving Global Outcome criteria, and patients were categorized into Stage 1 (n = 63), Stage 2 (n = 49), and Stage 3 (n = 38). Comprehensive clinical assessment, laboratory investigations, and outcome measures were analyzed.
Results: The mean age was 51.55 ± 20.76 years with 62% male predominance. BMI status showed a significant association with AKI severity (P = 0.020), with underweight patients comprising 42.1% of Stage 3 cases. Coronary artery disease demonstrated a strong positive correlation with AKI severity (P < 0.001), present in 11.1% of Stage 1 vs 73.7% of Stage 3 patients. Sepsis was significantly associated with AKI severity (P = 0.014), affecting 55.3% of Stage 3 patients. Inflammatory markers (C-reactive protein and procalcitonin) increased significantly with AKI severity (P = 0.001 and P < 0.001, respectively). Renal replacement therapy requirement increased from 0% in Stage 1 to 81.6% in Stage 3 (P < 0.001). Overall mortality was 10% with full renal recovery achieved in 53.3% of patients.
Conclusion: AKI in critically ill patients shows significant associations with coronary artery disease, malnutrition, sepsis, and systemic inflammation. Despite the serious nature of severe AKI, encouraging recovery rates were observed across all stages when managed in specialized intensive care settings.
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