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Peer-reviewedCC BYWellcome open research

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

  • Kalpana Kharbuja1,2
  • Sangina Ranjit1,2
  • Diptesh Aryal2,3,4
  • Subekshya Luitel2
  • Ajit Pandey1
  • Pratikshya Timilsina1
  • Alisha Bajracharya1,2
  • Sujata Pasachhen1
  • Surendra Bhusal2,5
5 affiliations
  1. 1Department of Anaesthesia & critical care, Dhulikhel Hospital, Dhulikhel, Central Development Region, 45210, Nepal.
  2. 2Nepal Intensive Care Research Foundation, Kathmandu, Central Development Region, Nepal.
  3. 3Faculty of Tropical Medicine, Mahidol University,, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Bangkok, Thailand.
  4. 4D'Or Institute for Research and Education, Rio de Janeiro, State of Rio de Janeiro, Brazil.
  5. 5Department of Anaesthesia and Critical Care, Bir Hospital, Kathmandu, Central Development Region, Nepal.
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Abstract

Background

Acute kidney injury is common among critically ill patients and is associated with longer ICU stay, higher resource use and increased mortality. Evidence from low- and middle-income countries, including Nepal, remains limited. This study describes the incidence, severity distribution and clinical outcomes of AKI in a tertiary care ICU.Methods

We conducted a hospital based retrospective observational study at Dhulikhel Hospital, Nepal. All adults admitted to the ICU from 1 st may 2023 to 30 th April 2024 were screened using ICU registry. AKI was defined and staged using KDIGO serum criteria. Demographic data, comorbidities, ICU interventions and outcomes were extracted. Associations were examined using appropriate statistical tests.Results

Among 1113 patients, 1064 were enrolled for analysis. The incidence of AKI was 29.6%. Patients with AKI were older (median age 60 vs 55 years, p < 0.001), had longer ICU stays (median 3 vs 2 days, p < 0.001), were more frequently on invasive mechanical ventilation (39.6%vs 26%, p < 0.001). Type 2 diabetes mellitus was significantly associated with AKI (39.0% vs 28.0%, p = 0.001). AKI severity correlated with worse outcomes including higher mortality and adverse outcomes increasing from 12.7% in patients without AKI to 38% in stage 3 AKI. Renal replacement therapy was required in 2.3% of patients, mainly in stage 2 and 3 AKI.Conclusion

Acute kidney injury is a common and a serious complication among critically ill patients, associated with increased mortality and prolonged ICU stay. Early recognition and targeted management strategies, particularly for high-risk groups, are needed in resource limited settings.

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Cite

BibTeXRIS
BibTeX
@article{kharbuja2026incidence,
  title = {{Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients: A Retrospective Study at a Tertiary Care Hospital.}},
  author = {Kalpana Kharbuja and Sangina Ranjit and Diptesh Aryal and Subekshya Luitel and Ajit Pandey and Pratikshya Timilsina and Alisha Bajracharya and Sujata Pasachhen and Surendra Bhusal},
  journal = {Wellcome open research},
  year = {2026},
  month = oct,
  doi = {10.12688/wellcomeopenres.25698.2},
  url = {https://europepmc.org/article/MED/42959017},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Incidence and Outcomes of Acute Kidney Injury in Critically Ill Patients: A Retrospective Study at a Tertiary Care Hospital.
AU  - Kalpana Kharbuja
AU  - Sangina Ranjit
AU  - Diptesh Aryal
AU  - Subekshya Luitel
AU  - Ajit Pandey
AU  - Pratikshya Timilsina
AU  - Alisha Bajracharya
AU  - Sujata Pasachhen
AU  - Surendra Bhusal
PY  - 2026
DA  - 2026/10/13
JO  - Wellcome open research
DO  - 10.12688/wellcomeopenres.25698.2
UR  - https://europepmc.org/article/MED/42959017
AB  - Background  Acute kidney injury is common among critically ill patients and is associated with longer ICU stay, higher resource use and increased mortality. Evidence from low- and middle-income countries, including Nepal, remains limited. This study describes the incidence, severity distribution and clinical outcomes of AKI in a tertiary care ICU.Methods  We conducted a hospital based retrospective observational study at Dhulikhel Hospital, Nepal. All adults admitted to the ICU from 1 st may 2023 to 30 th April 2024 were screened using ICU registry. AKI was defined and staged using KDIGO serum criteria. Demographic data, comorbidities, ICU interventions and outcomes were extracted. Associations were examined using appropriate statistical tests.Results  Among 1113 patients, 1064 were enrolled for analysis. The incidence of AKI was 29.6%. Patients with AKI were older (median age 60 vs 55 years, p < 0.001), had longer ICU stays (median 3 vs 2 days, p < 0.001), were more frequently on invasive mechanical ventilation (39.6%vs 26%, p < 0.001). Type 2 diabetes mellitus was significantly associated with AKI (39.0% vs 28.0%, p = 0.001). AKI severity correlated with worse outcomes including higher mortality and adverse outcomes increasing from 12.7% in patients without AKI to 38% in stage 3 AKI. Renal replacement therapy was required in 2.3% of patients, mainly in stage 2 and 3 AKI.Conclusion  Acute kidney injury is a common and a serious complication among critically ill patients, associated with increased mortality and prolonged ICU stay. Early recognition and targeted management strategies, particularly for high-risk groups, are needed in resource limited settings.
SN  - 2398-502X
ER  -