Clinical Profile and Predictors Affecting Outcome in Community-Acquired Acute Kidney Injury: A 3 Months Follow-Up Study

Abstract

Community-Acquired Acute Kidney Injury (CA-AKI) is often a devastating clinical syndrome allied with high hospital mortality. Moreover, only limited prospective data exist on the outcomes of CA-AKI. Hence, this follow-up study was conducted to assess clinical profiles and the factors affecting outcomes in CA-AKI. A prospective study enrolling 283 participants was conducted from the year 2021 to 2022. AKI patients defined as per Kidney Disease Improving Global Outcomes (KDIGO) criteria were included. Data were collected on demographics, clinical features, and etiological factors. Patients were followed for three months. Univariate and multinomial analyses were done to predict outcomes. The Cox regression model was fitted to identify predictors of mortality. The mean age of patients was 41.67±16.21 years with male predominance. Most of the patients required non-ICU (81.9%) care. Around 36% and 39.6 % of AKI patients were oliguric and required dialysis, respectively. Most patients had a single etiology, with sepsis being the most common cause. Most patients were in KDIGO stage 3, followed by stage 2. At three months of follow-up, 40.6%, 12.3%, and 4.2% had complete, partial, and non-recovery, respectively, and 30.4% died. Age, single etiology, hepatorenal syndrome, sepsis, requirement of mechanical ventilation and vasopressors, comorbidities and glomerulonephritis were significantly associated with mortality. CA-AKI is significantly associated with higher mortality, even for those patients who require non-ICU care on presentation. This highlights the pressing need for AKI prevention, early detection, and intervention to mitigate reversible risk factors and optimize clinical outcomes.