Predictors of Renal Recovery and Mortality in Patients with Acute Kidney Injury in a Tertiary Center

Background: Acute and chronic kidney diseases remain major causes of morbidity and mortality among hospitalized patients. Identifying predictors of renal recovery and survival is essential for improving prognosis and optimizing management strategies in nephrology settings. Objectives: To evaluate kidney function outcomes and determine independent predictors of renal recovery and in-hospital mortality among patients admitted to the Nephrology Department, Minia University Hospital. Methods: This prospective observational study included 400 consecutive kidney-disease patients admitted between December 2023 and July 2024. Detailed demographic, clinical, laboratory, and imaging data were collected. Patients were classified into resolving versus non-resolving kidney injury groups, and survivors versus non-survivors. Logistic regression analyses were performed to identify independent predictors of renal recovery and mortality. Results: Renal recovery occurred in 73 % of patients, while overall in-hospital mortality was 7.8 %. Resolving cases had significantly higher baseline eGFR, hemoglobin, and mean arterial pressure, and lower serum creatinine, potassium, and CRP levels (p < 0.05). Independent predictors of renal recovery included higher baseline eGFR (OR 1.32, 95 % CI 1.10–1.59) and absence of sepsis (OR 2.41, 95 % CI 1.16–5.01). Mortality was independently associated with older age (OR 1.08 per year), need for mechanical ventilation (OR 5.94), and low mean arterial pressure (OR 0.92 per mmHg). Conclusions: Among hospitalized nephrology patients, preserved kidney function, stable hemodynamics, and absence of sepsis predicted renal recovery, whereas advanced age and critical illness increased mortality. Early risk stratification and targeted interventions may improve short-term outcomes in similar hospital populations.