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Abstract

Objectives To analyze the causes and epidemiology of patients undergoing acute hemodialysis in our locality. Background Acute kidney injury (AKI) is associated with high morbidity and mortality. It is a major indication for renal replacement therapy in the ICU. An important fraction of renal replacement therapy-treated AKI progresses to chronic kidney disease (CKD), while patients with CKD constitute a large fraction of patients with AKI. Patients and methods This was a retrospective observational cohort study including patients presented to acute hemodialysis at the hemodialysis unit of a tertiary care center over a period of 2 years (from January 2016 to December 2017). Results A total of 167 patients were included. Patients were classified into three groups: group 1 included 76 (45.5%) patients with AKI, group 2 included 28 (16.8%) patients with AKI on top of CKD, and group 3 included 63 (37.7%) patients who were diagnosed with end-stage kidney disease for the first time on presentation to dialysis. The most common causes of AKI in group 1 were infection, obstructive uropathy, and hypovolemia. The most common causes of AKI in group 2 were infection, obstructive uropathy, and toxin/drug-induced. Patients in group 3 were older; 55.56% of them were hypertensive, and one-third of them were diabetic. Conclusions The major causes of AKI-requiring dialysis were infection, hypovolemia, and obstructive uropathy. A significant proportion of patients in this study were either crash or unplanned starters of dialysis; this proportion can be reduced by screening programs for renal disease at a national level.

Subject Area

Internal Medicine

Article Type

Original Study

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