Unveiling AKI at Mansoura Nephrology and Dialysis Unit: predictors of renal recovery and In-hospital mortality

Background: Acute kidney injury (AKI) is a global health concern associated with high morbidity, mortality, and healthcare costs. Despite advances in prevention and management, in-hospital mortality remains significant, especially among critically ill patients. Objectives: This study assessed the incidence, risk factors, and outcomes of AKI in patients admitted to Mansoura Nephrology and Dialysis Unit (MNDU), a large tertiary renal center at Dakahlia governorate, over one year and evaluated predictors of renal recovery and in-hospital mortality. Methods: A prospective observational study was conducted from June 2022 to May 2023, including patients admitted with renal disorders. Statistical analyses identified predictors of renal recovery and mortality. Results: The study included 839 adult patients with renal disorders. Patients were classified into AKI (330, 39.3%) and non-AKI (509, 60.7%) groups. The most common AKI causes were pre-renal (54.2%), intrinsic (39.0%), and post-renal (7%). Mortality was significantly higher in the AKI group (17.3% vs. 3.8%), with septic shock as the leading cause (84.2%). Among AKI patients, 45% achieved complete recovery, 21.8% partially recovered and 33% had no recovery. At admission, younger age, female gender, and higher urine output (UOP) were associated with better renal recovery, while lower serum phosphate and higher uric acid levels predicted renal recovery and mortality, respectively. Conclusions: AKI remains among major causes of hospitalization and in-hospital mortality, with septic shock as the primary contributor. Early recognition is essential. Admission UOP and serum phosphate independently predicted renal recovery, while serum uric acid predicted mortality. These simple admission parameters may help identify high-risk patients.