Etiology and Outcomes of Acute Kidney Injury: A Comprehensive Study in Four Tertiary Centers of Dhaka

This study was conducted to determine the etiology and outcomes of AKI in 4 tertiary centers of Dhaka, Bangladesh irrespective of RRT requirement and the hospital setting in which they were treated.
This retrospective study was carried out in 4 tertiary care centers (Bangabandhu Sheikh Mujib Medical University, National Institute of Kidney Disease and Urology, Dhaka Shishu Hospital, and Dhaka Medical College Hospital) and 3 NICUs (Bangabandhu Sheikh Mujib Medical University, Dhaka Shishu Hospital and Dhaka Medical College Hospital of Dhaka) from January 2013 to December 2014. For the purpose of this study, AKI was defined according to the pediatric RIFLE (risk, injury, failure, loss, and end stage) criteria. All children admitted to the Pediatric Nephrology Inpatient Department and NICU of these hospitals were enrolled in the study. Data were collected from the registry of the hospitals. Ethics approval was obtained from the Institutional Review Board.
A total of 2285 patients in the Nephrology Ward and 3764 patients in the NICU were included in the study. About 8.1% (185) of the patients had AKI, and the death rate was 18.5%. Out of 3764 children in the NICU, 530 had AKI and 17.2% of the patients died.
The renal cause of AKI was the most predominant causes in our setting in hospitalized patients and perinatal asphyxia was a predominant cause of AKI in neonates. The overall mortality rate was 13-26%, which is comparable to other South Asian countries.