RISK FACTORS AND OUTCOME OF HOSPITAL ACQUIRED ACUTE RENAL FAILURE

Background: Acute renal failure is a frequently encountered problem in hospitalized patients. The etiology of hospital acquired acute renal failure (HAARF) is multi-factorial and it is commonly associated with an increased risk of morbidity and mortality in such patients. The objective of this study was to assess the risk factors and outcomes in patients who developed Hospital Acquired Acute Renal Failure. Materials & Methods: A cross sectional study was carried out at Medical Unit-II, Nishtar Hospital. Multan, from 01/01/2020 to 30/06/2020. A total of 50 patients were included in the study after identification of clinical features of HAARF on detailed history and clinical examination. Relevant investigations, including renal parameters, serum electrolytes and ultrasonography abdomen were performed. All the data was entered in SPSS and was analyzed using mean +/- S.D and frequency (%). Results: The study included total 56 patients in which 26 (52%) were male patients and 24 (48%) were female patients. Mean age of patients was 56.70 +/- 11.70 years. The use of nephrotoxic drugs was the commonest risk factor (40.0%) for developing HAARF, followed by sepsis (28.0%), post-surgical (20.0%), use of radio-active agents (8.0%), and decreased renal perfusion (4.0%). Twenty (40%) patients had complete recovery while partial recovery was noticed in 10 (20%) patients. In 8 (16%) patients, there was no recovery. Death occurred in 12 (24.0%) patients as a result of HAARF. 25 (50%) patients required hemodialysis. The ICU care/ ventilator support was needed in 16 (32%) patients. Multi organ failure was noticed in 16 (32%) patients. Duration of the hospital stay for all 50 patients was more than 14 days. Conclusion: Nephrotoxic drugs, sepsis, surgery, radio-contrast agents, and reduced renal perfusion are the most important risk factors for hospital acquired acute renal failure. HAARF is also associated with high morbidity and mortality. Ample steps should be taken to provide appropriate medical care in order to prevent adverse outcomes in hospitalized patients.