CLINICAL PROFILE AND OUTCOMES OF PATIENTS WITH ACUTE KIDNEY INJURY ADMITTED TO A TERTIARY CARE HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Acute kidney injury (AKI) is a common and potentially life-threatening complication encountered in hospitalized patients, particularly among those with severe acute illnesses and multiple comorbidities. It is characterized by an abrupt decline in renal function that results in the accumulation of metabolic waste products, disturbances in fluid and electrolyte balance, and an increased risk of short- and long-term adverse outcomes. Despite advances in critical care and renal replacement therapies, AKI continues to be associated with substantial morbidity, prolonged hospitalization, increased healthcare costs, and high mortality rates worldwide. The burden of AKI is especially significant in tertiary-care hospitals, where patients often present with complex medical conditions, severe infections, hemodynamic instability, and multiorgan dysfunction. Understanding the clinical characteristics, underlying causes, and outcomes of AKI is essential for developing effective preventive and therapeutic strategies. Therefore, the present prospective observational study was conducted among 180 adult patients diagnosed with AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Participants were comprehensively evaluated with respect to demographic characteristics, clinical presentation, AKI stage, and underlying aetiology and were followed until hospital discharge or death. Particular attention was given to identifying common causes of AKI, assessing disease severity, and evaluating important clinical outcomes, including renal recovery, requirement for dialysis, and in-hospital mortality. The study findings demonstrated that pre-renal causes and sepsis-associated AKI were among the most frequent aetiologies, highlighting the critical role of circulatory compromise and systemic infection in the development of acute renal dysfunction. A substantial proportion of patients achieved partial or complete recovery of renal function during hospitalization, reflecting the potentially reversible nature of AKI when promptly recognized and appropriately managed. However, mortality remained considerable, particularly among patients with severe disease. Higher KDIGO stage, the presence of sepsis, oliguria, requirement for dialysis, and the need for mechanical ventilation were all significantly associated with increased in-hospital mortality, indicating that both the severity of kidney injury and the extent of systemic illness contribute substantially to patient outcomes. These findings underscore the importance of early diagnosis, close monitoring of renal function, timely correction of haemodynamic disturbances, aggressive management of sepsis, and appropriate initiation of renal replacement therapy when indicated. Overall, the study highlights that AKI in a tertiary-care setting is frequently related to preventable or treatable causes and that improved clinical vigilance, early intervention, and multidisciplinary management may play a pivotal role in reducing mortality and improving renal recovery among affected patients.