Spectrum of acute kidney injury in a tertiary care hospital in Cairo.

INTRODUCTION: Data concerning the spectrum of acute kidney injury (AKI) in Egypt are scarce. The study aims to describe the spectrum of AKI in a tertiary hospital in Cairo.

METHODS: We retrospectively collected the data of all cases of AKI who were treated at Dar El Shefa Hospital, Cairo, Egypt, from January 2006 to January 2007.

RESULTS: There were 51 cases of AKI during the study period (29 males and 22 females). Their age ranged from 19 to 81 years with a mean of 48 years. Pre-renal azotemia and acute tubular necrosis (ATN) accounted for 53% of all cases. These were due to cardiovascular disease in ten patients, sepsis in six patients, obstetrical complications in five patients, post surgical in four patients, trauma in one patient and gastroenteritis in one patient. Contrast induced nephrotoxicity was responsible for AKI in eight cases (15.7%), glomerulonephritis/vasculitis in eight (15.7%), obstructive uropathy in five (9.8%) acute interstitial nephritis in two (3.9%), and acute urate nephropathy in one (2%). Thirty cases were treated conservatively, nineteen received hemodialysis, and two received peritoneal dialysis. Average duration of hospital stay was 11.7 days. Out of the fifty one cases, thirty-three recovered normal renal function (64.7%), eleven expired, five progressed to chronic kidney disease and two were lost follow up. Overall mortality was 21.5%.

CONCLUSION: The common causes of acute kidney injury in our setting were pre-renal azotemia and ATN due to acute cardiovascular disease (19.6%), contrast induced nephrotoxicity (15.6%), glomerulonephritis (15.6%) and sepsis induced ATN (11.7%). Most cases were managed conservatively and two thirds recovered their normal kidney function.