Sreevyshali M S, Vaishnavi Venkat, Apoorva Dev*, Gorakati Pradeep Reddy, Hemant H R
Back ground: Hospital-Acquired Acute Kidney Injury (HAAKI) is associated with higher length of stay, morbidity, mortality and cost among hospitalized patients. If managed adequately and in a timely manner, the majority of cases are preventable, treatable and often reversible with simple measures. Objectives: To establish the incidence, risk factors and attributable mortality associated with HAAKI in the patients admitted in MICU using the staging given by KDIGO guidelines. Methodology: A prospective observational study was carried out from October 2018 to March 2019. In a specially designed proforma patient details were collected. AKI was defined and staged according to KDIGO criteria. Results were analysed using logistic regression method, Chi-square test, Z-test, descriptive analysis. SPSS software was used for analysis. Results: Of a total of 200 admissions in MICU, 46 (23%) patients developed HAAKI. The mean time for AKI attack was found to be day 4. Common comorbid risk factors for HAAKI was found to be sepsis (73.9%), diabetes (54.3%), hypertension (52.2%), cardiovascular diseases (50%), pneumonia (34.8%), MODS (32.6%), hypotension (32.6%), CKD (30.4%), ARDS (30.4%). The most common risk factor for the development of HAAKI was administration of nephrotoxic medications (93.5%). Death occurred in 41.3% of the patients who had HAAKI as an attributable risk. MODS and ARDS were found to be the significant risk factor that leads to the mortality in HAAKI patients. Conclusion: Common risk factors of developing HAAKI were older age, male gender, sepsis, pneumonia, cardiovascular diseases, CKD. It is important to develop strategizing approaches for early detection and prevention of HAAKI. Key words: HAAKI (Hospital Acquired Acute Kidney Injury), KDIGO (Kidney Disease Improving Global Outcomes), attributable mortality, incidence.