A prospective study of acute kidney injury in intensive care setting according to Rifle definition and its mortality predictors

SHARHAN P.P *, HABIBULLA D ATTAR, MUHAMMED MUSHTAQ AHMED and SAIFUDDIN SARGIRO

Department of General Medicine, Al-Ameen Medical College and Hospital, Vijayapura, Karnataka, India.
 
Research Article
International Journal of Science and Research Archive, 2024, 13(01), 2614–2623.
Article DOI: 10.30574/ijsra.2024.13.1.1942
Publication history: 
Received on 02 September 2024; revised on 14 October 2024; accepted on 16 October 2024
 
Abstract: 
Background: Acute Kidney Injury (AKI) in ICUs is associated with high morbidity, mortality, prolonged hospital stays, increased costs, and risk of progression to Chronic Kidney Disease (CKD). Early identification of AKI is essential.
Aims and Objectives: To determine the incidence of AKI in ICU patients using the RIFLE criteria.
·         To identify etiological factors and comorbid conditions associated with AKI.
·         To assess the outcomes of AKI based on the RIFLE criteria.
·         To explore age, gender, serum creatinine, Fe Na, and urine spot Na as predictors of AKI mortality.
Materials and Methods: A prospective observational study was conducted at Al-Ameen Medical College and Hospital, Vijayapura, with 83 patients over two years. ICU patients were monitored for AKI development using the RIFLE criteria.
Results: Univariate logistic regression showed oliguria as a significant predictor of mortality (OR: 0.461). Among AKI survivors (n=51), the highest number (41.2%) were aged 50–59 years. In AKI deaths (n=32), most (40.6%) were over 60 years. Sepsis (39.2%) and shock (31.4%) were common in survivors, while sepsis (71.9%) dominated among deaths
Conclusion: Early identification of high-risk AKI patients is crucial. Infections and hypotension drive significant mortality risk. Oliguric patients and those on ventilation require close monitoring. Timely diagnosis and management, especially of infections and multi-organ dysfunction, are key to improving outcomes. Haemodialysis was the preferred treatment.
 
Keywords: 
Risk prediction model RIFLE criteria;Acute kidney injury (AKI); Intensive Care Unit (ICU); Chronic kidney injury (CKD);Glomerular filtration rate (GFR); Fractional excretion of sodium (FE Na)
 
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