Frequency and Outcomes of Acute Kidney Injury among Patients admitted to the Medical Ward of a Tertiary Care Hospital

Abstract

Objective: To determine the frequency and outcomes of acute kidney injury (AKI) among patients admitted to the medical ward of a tertiary care hospital, and to identify factors associated with in-hospital mortality.

Methodology: This descriptive cross-sectional study was conducted in the Medical Ward of Akbar Niazi Teaching Hospital, Islamabad, from January 2026 to April 2026. Patients aged 18–80 years who developed AKI and stayed longer than 48 hours were included through consecutive sampling. ICU patients, dialysis-dependent patients, transplant recipients, and those with an admission creatinine above 5 mg/dL were excluded. AKI was diagnosed and staged using KDIGO criteria. Data were analysed using SPSS version 26. Associations with mortality were assessed using the Chi-square or Fisher's exact test, with p<0.05 considered significant.

Results: Of 1470 admissions, 234 patients developed AKI, giving a frequency of 15.9%. The mean age was 60.4 ± 15.2 years, and 148 (63.2%) were male. Hypertension (52.1%) and diabetes (40.2%) were the most common comorbidities. Stage 3 AKI was present in 126 (53.8%) patients. No patient required dialysis. In-hospital mortality was 14.5%. Sepsis, septic shock, vasopressor use, and Stage 3 AKI were significantly associated with mortality. Septic shock was the strongest predictor (p=0.009). Hypertension and diabetes were not associated with mortality.

Conclusion: AKI affected about one in six medical ward admissions and was often severe. Mortality was driven mainly by sepsis, not chronic comorbidities. Early detection of AKI and prompt sepsis management are essential to improve outcomes.