Frequency of Acute Kidney Injury in Patients Presenting with Acute Pyelonephritis at Tertiary Care Hospital, Karachi

Authors

  • Soniya Department of Internal Medicine, Medical Unit 2 Ward 6, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
  • Rukhshanda Jabeen Department of Internal Medicine, Medical Unit 2 Ward 6, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
  • Guriya Department of Internal Medicine, Medical Unit 2 Ward 6, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
  • Lubna Gul Department of Internal Medicine, Medical Unit 2 Ward 6, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
  • Ayesha Ejaz Department of Internal Medicine, Medical Unit 2 Ward 6, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
  • Kashish Department of Medicine, Medicine Ward 4, Liaquat University of Medical and Health Sciences (LUMHS), Hyderabad, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i6.1912

Keywords:

Acute kidney injury, Acute pyelonephritis, Risk factors, Diabetes mellitus, Hypertension, Dyslipidemia, Smoking.

Abstract

Objective: To determine the frequency of acute kidney injury in patients presenting with acute pyelonephritis at Tertiary Care Hospital, Karachi. Methods: A total of 141 patients were included in this hospital-based cross-sectional study. Baseline characteristics such as age, gender, diabetes mellitus, hypertension, dyslipidemia, and smoking status were recorded. The presence of AKI was determined, and its association with these factors was analyzed. Results: AKI was diagnosed in 58.2% of participants, while 41.8% did not develop the condition. The majority of patients (68.1%) were between 46 and 75 years old, and the gender distribution was nearly equal (49.6% male, 50.4% female). Diabetes mellitus was present in 19.9%, hypertension in 28.4%, dyslipidemia in 8.5%, and 36.2% of participants were smokers. However, none of these factors showed a statistically significant association with AKI development (p > 0.05 for all variables). Conclusion: More than half of the patients with acute pyelonephritis developed AKI, yet no specific risk factor emerged as a significant predictor. This suggests that AKI in this population is likely influenced by a combination of factors rather than any single underlying condition. Further research with larger, multi-center cohorts and long-term follow-up is needed to better understand the risk factors and improve early detection and management strategies.

Downloads

Download data is not yet available.

References

1. Ki M, Park T, Choi B. The epidemiology of acute pyelonephritis in South Korea, 1997–1999. Am J Epidemiol. 2004;160:985–93.

https://doi.org/10.1093/aje/kwh308

2. Ramakrishnan K, Scheid DC. Diagnosis and management of acute pyelonephritis in adults. Am Fam Phys. 2005;71:933–42.

3. Piccoli GB, Consiglio V, Deagostini MC. The clinical and imaging presentation of acute "non complicated" pyelonephritis: a new profile for an ancient disease. BMC Nephrol. 2011;12:68.

https://doi.org/10.1186/1471-2369-12-68

4. Akram AR, Singanayagam A, Choudhury G. Incidence and prognostic implications of acute kidney injury on admission in patients with community-acquired pneumonia. Chest. 2010;138:825–32.

https://doi.org/10.1378/chest.09-3071

5. Naqvi R. Epidemiological trends in community acquired acute Kidney Injury in Pakistan: 25 years Experience from a Tertiary Care Renal Unit. Pak J Med Sci. 2021 Mar-Apr;37(2):312-319.

https://doi.org/10.12669/pjms.37.2.3876

6. Hoste EAJ, Clermont G, Kersten A. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care. 2006;10:R73.

https://doi.org/10.1186/cc4915

7. Ostermann M, Chang RWS. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med. 2007;35:1837–43.

https://doi.org/10.1097/01.ccm.0000277041.13090.0a

8. Uchino S, Kellum JA, Bellomo R, et al.. Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators: acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–18.

https://doi.org/10.1001/jama.294.7.813

9. Jang SH, Lee CS, Lee MY. Clinical differences in acute kidney injury between unilateral acute pyelonephritis and bilateral acute pyelonephritis. Korean J Med. 2012;82:696–03.

https://doi.org/10.3904/kjm.2012.82.6.696

10. Lee YJ, Cho S, Kim SR. Unilateral and bilateral acute pyelonephritis: differences in clinical presentation, progress and outcome. Postgrad Med J. 2014;90:80–85.

https://doi.org/10.1136/postgradmedj-2013-131935

11. Jones J, Holmen J, De Graauw J. Association of complete recovery from acute kidney injury with incident CKD stage 3 and all-cause mortality. Am J Kidney Dis. 2012;60:402–08.

https://doi.org/10.1053/j.ajkd.2012.03.014

12. Mammen C, Al Abbas A, Skippen P. Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: a prospective cohort study. Am J Kidney Dis. 2012;59:523–30.

https://doi.org/10.1053/j.ajkd.2011.10.048

13. Jeon DH, Jang HN, Cho HS, Lee TW, Bae E, Chang SH, Park DJ. Incidence, risk factors, and clinical outcomes of acute kidney injury associated with acute pyelonephritis in patients attending a tertiary care referral center. Ren Fail. 2019 Nov;41(1):204-210.

https://doi.org/10.1080/0886022x.2019.1591995

14. Chawla LS, Kimmel PL. Acute kidney injury and chronic kidney disease: an integrated clinical syndrome. Kidney Int. 2012;82(5):516-24.

https://doi.org/10.1038/ki.2012.208

15. Coca SG, Singanamala S, Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int. 2012;81(5):442-48.

https://doi.org/10.1038/ki.2011.379

16. Neugarten J, Golestaneh L. Gender and the prevalence and progression of renal disease. Adv Chronic Kidney Dis. 2013;20(5):390-95.

https://doi.org/10.1053/j.ackd.2013.05.004

17. Silbiger SR, Neugarten J. The impact of gender on the progression of chronic renal disease. Am J Kidney Dis. 1995;25(4):515-33.

https://doi.org/10.1016/0272-6386(95)90119-1

18. Kitchlu A, Adhikari NKJ, Bagshaw SM, et al. Diabetes and risk of acute kidney injury in critically ill patients. Am J Kidney Dis. 2019;74(3):330-39.

19. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-84.

https://doi.org/10.1159/000339789

20. Siew ED, Davenport A. The growth of acute kidney injury: a rising tide or just closer attention to detail? Kidney Int. 2015;87(1):46-61.

https://doi.org/10.1038/ki.2014.293

21. Coca SG, Yusuf B, Shlipak MG, et al. Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009;53(6):961-73.

https://doi.org/10.1053/j.ajkd.2008.11.034

22. Park M, Hsu CY, Go AS, et al. Association of kidney function and metabolic risk factors with density of glomeruli. J Am Soc Nephrol. 2020;31(9):2106-15.

23. Wilson FP, Yang W, Machado CA, et al. Dyslipidemia and risk of AKI after cardiac surgery. Am J Kidney Dis. 2014;63(4):579-88.

24. Mohamed A, Douglas IS, Coopersmith CM. Diabetes in the ICU: a narrative review. Chest. 2021;159(3):1046-59.

25. Lapi F, Azoulay L, Yin H, et al. Concurrent use of diuretics, angiotensin receptor blockers, and NSAIDs and risk of acute kidney injury: a population-based study. BMJ. 2013;346:e8525.

https://doi.org/10.1136/bmj.e8525

26. Perazella MA. The kidney in heart failure: prevalence and prognostic implications. Nat Rev Nephrol. 2013;9(6):313-20.

https://doi.org/10.1038/nrneph.2013.80

27. Eriksen BO, Palsson R, Ebert N, et al. GFR in healthy aging: an individual participant data meta-analysis. J Am Soc Nephrol. 2020;31(7):1602-15.

https://doi.org/10.1681/asn.2020020151

28. Susantitaphong P, Cruz DN, Cerda J, et al. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol. 2013;8(9):1482-93.

https://doi.org/10.2215/cjn.00710113

29. Kellum JA, Lameire N. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary. Nat Rev Nephrol. 2013;9(3):141-50.

https://doi.org/10.1186/cc11454

Downloads

Published

2025-06-30

How to Cite

Soniya, Jabeen, R., Guriya, Gul, L., Ejaz, A., & Kashish. (2025). Frequency of Acute Kidney Injury in Patients Presenting with Acute Pyelonephritis at Tertiary Care Hospital, Karachi. Indus Journal of Bioscience Research, 3(6), 918-921. https://doi.org/10.70749/ijbr.v3i6.1912