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Year : 2021  |  Volume : 7  |  Issue : 1  |  Page : 21-25

Epidemiology and outcomes of community-acquired-acute kidney injury in women: A study from tertiary care center in South India

Department of Nephrology, Gandhi Medical College, Hyderabad, Telangana, India

Correspondence Address:
Dr. Manjusha Yadla
Department of Nephrology, Gandhi Medical College, Hyderabad - 500 073, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jrnm.jrnm_3_21

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Introduction: Acute kidney injury (AKI) is sudden deterioration in kidney function for few days to weeks with or without kidney damage. Risk factors for AKI are diabetes, hypertension, pre-existing chronic kidney disease (CKD), and advanced age. Apart from the traditional risk factors, K-DOQI mentions the female gender as susceptibility factor for the development of AKI. Although it is well known that certain hospital-acquired causes of AKI such as contrast-induced nephropathy, aminoglycoside toxicity, care common in women, community acquired etiology is not well studied. Hence, we undertook this study to analyze community-acquired (CA)-AKI in women and their outcomes. Aim: The aim is to study the epidemiology and outcome of AKI in women. Material and Methods: A retrospective analysis of medical records of patients admitted with the diagnosis of AKI during the calendar year of 2018 was done. Data were collected from the computer system of the Aarogasree scheme, a flagship scheme of the Government providing cashless health services to the below poverty line patients. Under this, Code 6 is for Nephrology, 6.1 is for AKI. Demographic data, investigations, hospital stay, and treatment details are entered into the system. Patients with the final diagnosis of Acute on CKD and chronic dialysis were excluded. Age, gender, etiology, management, and the association between treatment and outcome were analyzed using descriptive statistics, and Chi-square test. The primary outcome analyzed was mortality. The secondary outcome in the form of geographical predisposition for the development of specific causes of AKI was also analyzed. Telangana State is divided into seven Zones geographically. We tried to analyze etiology and outcomes of AKI in these individual Zones. Results: A total of 390 patients were admitted with AKI as the presenting diagnosis to the female nephrology ward and intensive care unit (ICU) in our hospital. Out of 390 patients, 180 patients were excluded from the study. 210 patients were included in the study. The mean age of patients is 46.9 ± 16.2 years. Oliguria was presenting complaints in 33.8% and fever in 25.2% of patients with AKI. Febrile illness (22%) and acute gastroenteritis (15%) were major causes of AKI, followed by carcinoma cervix (14%) and PR-AKI (10%). Around one-third of patients belong to Zone 6 of Telangana state. The intrinsic renal cause was found to be the predominant cause of AKI in all zones except Zone 5 and Zone 7. Mortality was found to be highest (25%) in zone 4 followed by zone 2 (17.6%). The lowest mortality was found in Zone 1 and Zone NA (0%). No statistical significance was found for outcomes between those admitted to ICU and ward. The presence of diabetes (P = 0.53) or hypertension (P = 0.47) was not associated with increased mortality. Conclusion: Oliguria and fever are common clinical presentations of AKI in women. Febrile illness and acute gastroenteritis are the most common causes of AKI in women. Intrinsic renal cause for AKI was found to be common in all zones of Telangana state except Zone 5 and Zone 7 where post renal cause for AKI was predominant. Zone 4 and Zone 2 which are far from Zone 6 had the highest mortality. Neither diabetes mellitus nor hypertension was associated with increased mortality.

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