Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients: A Retrospective Study at a Tertiary Care Hopsital

This study aims to identify the incidence and clinical outcomes of acute kidney injury (AKI) among critically ill patients admitted to a tertiary care intensive care unit in Nepal. Using ICU registry data from over 1,000 adult patients admitted between May 2023 and April 2024, researchers found that nearly one in three patients (29.6%) developed AKI during their ICU stay. Patients who developed AKI were generally older, had longer ICU stays, and were more likely to require invasive mechanical ventilation. AKI was particularly common among patients with diabetes, sepsis, cardiovascular disease, and pre-existing renal conditions.
The severity of AKI was strongly associated with worse outcomes. As AKI progressed from mild to severe stages, the proportion of patients experiencing adverse outcomes and death increased substantially, with mortality rising from 12.7% in patients without AKI to 38% in those with severe (stage 3) AKI. Although only a small proportion of patients required renal replacement therapy (2.3%), the need for dialysis increased markedly in advanced AKI stages. Overall, patients with AKI had higher mortality, longer ICU stays, and poorer discharge outcomes compared to those without AKI.
The findings highlight AKI as a common and serious complication in Nepalese ICUs, particularly among older patients and those with metabolic or infectious comorbidities. The study underscores the importance of early identification of high-risk patients, closer monitoring, and timely supportive care to reduce preventable deaths in resource-limited critical care settings.