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Subject Area

Internal Medicine

Article Type

Original Study

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.

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