Analysis of short term outcome of acute kidney injury network stage III of acute kidney injury.

Rajarajan, T (2013) Analysis of short term outcome of acute kidney injury network stage III of acute kidney injury. Masters thesis, Stanley Medical College, Chennai.


Download (1MB) | Preview


INTRODUCTION : Acute Kidney injury (AKI) is a clinical syndrome characterized by the rapid fall in glomerular filtration rate (GFR)occurring over hours to days resulting in the accumulation of nitrogenous waste products as well as deregulation of fluids electrolytes and acid base balance. Although the precise occurrence of AKI is difficult to estimate, hospital based studies estimate its incidence to 3-7% . The incidence of AKI is increasing from 18 per 100000 from 1980 to 365 per 100000 in 2005. AKI causes significant morbidity and short term mortality of 50%. The discovery of Urinary and Serum Biomarkers has made the identification of AKI in its preclinical phase thereby allowing the clinicians to aggressively intervene to prevent further damage. The burden of AKI lies not only in in-hospital mortality and morbidity, but also in its long term outcome of progression to Chronic Kidney Disease. A traditional concept of regarding renal outcome after an episode of AKI that 5%experience no recovery, 5% manifest progressive renal dysfunction has changed considerably now. Recent studies have shown 10-40% of dialysis requiring AKI remain dialysis dependent. Also it increases the risk of developing progressive CKD by 28 folds. Time has evolved now to view AKI as part of AKI-CKD syndrome were AKI brings out subtle renal abnormalities to the fore. To emphasis the above mentioned points this study was done to analyze the characteristics and the short term outcome of severe AKI (AKIN stage III) patients admitted in Govt. Stanley Medical College and Hospital. AIM : To analyze the characteristics and short term (three month) outcome in Acute Kidney Injury (Acute Kidney Injury Network Stage III). CONCLUSIONS ; 1. Severe AKI (AKIN STAGE III) is common in the hospital setting. 2. The patients who receive RRT have significantly high risk of having high Serum creatinine at discharge, persistent hematuria and renal dysfunction at 3 months. 3. More than two thirds of AKIN III AKI patients have evidence of renal damage at discharge viz., proteinuria, hematuria and renal dysfunction at discharge. 4. Nearly one third of the survivors of severe AKI have evidence of residual renal involvement at 3 months. 5. The patients who have no evidence of residual renal involvement at discharge continue to be the same at 3 months. 6. The patients who are dialysis dependent at discharge continued to be dialysis dependent and vice versa. 7. All the patients who had persistent renal dysfunction have abnormal renal biopsy at 3 months. 8. Acute tubular necrosis (ATN) has the best prognosis among all the AKI histologies. Acute interstitial nephritis in isolation or in combination with ATN has worse prognosis causing persistent interstitial inflammation, fibrosis and tubular atrophy. 9. Discharge urinary abnormalities, Presentation & Discharge Sr. Creatinine are associated with persistent renal involvement at 3 months.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Analysis of short term outcome ; acute kidney injury ; network stage III ; acute kidney injury.
Subjects: MEDICAL > Nephrology
Depositing User: Kambaraman B
Date Deposited: 11 Jul 2017 06:20
Last Modified: 11 Jul 2017 06:20

Actions (login required)

View Item View Item