Changing epidemiology of acute renal failure at a tertiary care hospital in North India

Introduction: Acute kidney injury (AKI) is one of the most common clinical condition with a significant economic burden worldwide. Objective: This study was conducted to determine the aetiology, clinical presentation and outcome of AKI from 2012-2014 and compared these findings with historical controls (2007-2011). Patients and Methods: This was an observational prospective comparative study with two groups - historical control group (group 1; 2007-2011) and prospective group (group 2; 2012-2014). Patients of either gender or aged between 18 and 70 years with AKI were included in the study. Demographic details, clinical signs and symptoms, and laboratory evaluations were noted. Outcomes evaluated were etiological parameters of renal failure, the outcome of renal failure and histology. Results: A total of 100 patients were included in the study (group 1, n=50; group 2, n=50). Overall, demographics were comparable between the two groups. Oliguria or anuria was the commonest presentation. Proteinuria was found in 12% and 6% of patients in group 1 and group 2, respectively. The mean (SD) serum creatinine at presentation was 5.39 (2.49) and 4.93 (2.99) in two groups, respectively. The medical causes were the most common etiological parameters of AKI (76% versus 94% in groups 1 and 2, respectively). Post-surgical and obstetrics causes were less prevalent in group 2. Acute interstitial Nephritis was common histology pattern in both group 1 and 2. The frequency of haemodialysis increased in group 2 and the mortality was decreased in both groups. Conclusion: Results showed that some etiological factors were slowly becoming less prevalent, while others were becoming more important factors in the genesis of AKI