The relationship of prospective sociodemographic, etiological, clinical and laboratory characteristics of patients hospitalized with the diagnosis of acute kidney injury in the nephrology service of KTU Faculty of Medicine with the primary outcome

SUMMARY Objective: In our study, we aimed to determine the etiology and stage of patients hospitalized in our nephrology service with a diagnosis of acute kidney injury, to determine their sociodemographic characteristics, and to determine their clinical, laboratory and comorbidity conditions. We aimed to monitor the relationship of all these parameters with the need for permanent dialysis, mortality and chronicity development in a 3-month period after hospitalization and discharge. Materials and Methods: In this study, the data of a total of 28 patients diagnosed with acute kidney injury according to KDIGO criteria between April 2022 and December 2022 in the nephrology service of Karadeniz Technical University were prospectively examined. The sociodemographic, etiological, clinical and laboratory (creatinine, albumin, BUN, BUN/creatinine, eGFR, electrolytes, uric acid, WBC, hemoglobin, platelet, CRP, blood gas, urine tests) characteristics of the patients were compared with the primary outcome (chronicity development, permanent dialysis need). requirement and mortality) were evaluated. The patients were followed until discharge, and their 3rd month post-discharge check-ups were also examined. Findings: 75% of all patients were male, the median age was 66 years and the median BMI was 28 kg/m². According to the KDIGO guideline, 17.9% of all patients were AKI stage-1, 10.7% were AKI stage-2, and 71.4% were AKI stage-3. While 10 of the 28 patients had AKI without previous kidney damage, 18 of them had AKI due to CKD. The majority of the patients (64.3%) were primary school graduates and the majority of the patients (53.6%) lived in the city. While 32.1% of the patients had never smoked, 14.3% were active smokers. The most common comorbidities were found to be CKD (64.2%), HT (25%) and DM (21.4%), respectively. 82% of all patients were using multiple medications, 46% were using at least one NSAID, and 7% of them were using multiple NSAIDs. The complaints of the patients, in order of frequency, were nausea in 46.4%, loss of appetite in 28.6% and vomiting in 25%. The volume status of the majority of patients (80%) was hypovolemic at initial admission and at the service visit. The median creatinine level at admission of all patients was 4.4 mg/dL and the median eGFR was 12.5 mL/min/1.73 m². In our study, the need for permanent dialysis was detected in 25% of all patients, while 50% of the patients recovered without sequelae and 14.2% resulted in mortality. 75% of those who developed mortality had malignancy. Results: The presence of infection in patients with AKI stage 1 was found to be statistically significantly higher compared to patients with AKI stage 2-3. The difference between the creatinine, eGFR and potassium values of patients with AKI stage-1 and AKI stage-3 at the time of hospital admission and the eGFR and peak creatinine values measured on the day when creatinine peaked was found to be statistically significant. The lowest sodium values of patients with AKI stage-3 were found to be statistically significantly lower compared to patients with AKI stage-2. In patients who developed mortality, the magnesium level measured on the day when creatinine peaked was found to be statistically significantly lower than in patients who did not develop mortality. The presence of malignancy in the mortality group was found to be statistically significantly higher compared to the non-mortality group. Keywords: Acute kidney injury, chronic kidney disease, mortality