Renal Data from Asia-Africa: Outcome of sepsis-associated acute kidney injury in an intensive care unit: an experience from a tertiary care center of central Nepal

Acute kidney injury (AKI) is a common and major complication of sepsis. Sepsis-induced AKI is associated with higher morbidity and mortality. A prospective study was designed to include all the patients with a provisional diagnosis of sepsis with AKI admitted in our intensive care unit from August 2009 to September 2010. Detailed demographic data including various clinical parameters, co-morbidities,investigations,complications and outcome were entered in a designated proforman and were analyzed. A total of 53 subjects with the provisional diagnosis of sepsis with AKI were included in the study. The majority of patients (60.37%) were female. The mean age of the study population was 45.84 ± 20.5 years. Forty-nine percent of the subjects were 45 years old and 26.4% patients were 65 years. Among the co-morbid conditions,9.4% subjects had diabetes mellitus type 2. Among the primary causes of AKI,72% of the cases were due to medical causes,in which pneumonia was the major cause,and 28% were due to surgical causes,in which cholecystitis was the major cause. 47.1% cases expired,11.3% subjects left against medical advice and 41.5% cases had favorable outcome. Among the expired cases,20.7% subjects expired within 24 h; for others,the median hospital stay was four days. This prospective study showed that the major causes of AKI were medical illness and pneumonia. Mortality in sepsis-induced AKI is significantly high. This highlights the importance of prevention of AKI in sepsis by early and renal-friendly aggressive treatment of sepsis and the need for improvement in the management of such AKI cases.