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.
Methods: This descriptive cross-sectional study was conducted in the Medical Ward of Akbar
Niazi Teaching Hospital, Islamabad, from January 2026 to June 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.
Keywords: Acute kidney injury; KDIGO; Sepsis; In-hospital mortality; Tertiary care hospital