Risk Factors for Acute Kidney Injury in Septic Patients Presenting to Institute of Kidney Diseases (IKD) Peshawar

Background: Acute kidney injury (AKI) frequently develops in patients with sepsis and is recognized as a major factor increasing the risk of poor clinical outcomes. Despite extensive global research, there remains a lack of institutional data from public-sector nephrology centers in Pakistan, particularly in regions like Peshawar. Limited diagnostic resources, late presentations, and inadequate sepsis management protocols often contribute to renal injury in such settings. This study investigates the factors associated with AKI in patients hospitalized with sepsis at the Institute of Kidney Diseases (IKD), Peshawar. Methodology: The descriptive cross-sectional study included 142 adult patients with sepsis admitted to Institute of Kidney Diseases (IKD), Peshawar, during January to June, 2025. Information was collected through clinical records using a structured checklist, including demographic variables, comorbid conditions, sepsis sources, treatment modalities, and laboratory indicators. AKI was identified using KDIGO criteria. Data analysis was performed using SPSS version 25, with significance set at p<0.05. Results: Among the study population, 35.2% developed AKI, and nearly one in four of those required dialysis. The average patient age was 49.13 years, and males constituted 73.2% of the sample. Common comorbidities included hypertension (59.2%) and diabetes (31%). Urinary tract infections were the leading cause of sepsis (59.2%), followed by respiratory and abdominal sources. Use of nephrotoxic drugs such as NSAIDs (23.2%) and IV contrast (21.8%) was frequently reported. Only 1.4% of patients received antibiotics later than three hours after admission. The mortality rate in this cohort was 14.1%. Conclusion: The study confirms that AKI is a common complication among septic patients in this setting, influenced by both clinical and therapeutic factors. Prompt sepsis management, cautious use of potentially harmful medications, and proactive renal monitoring are essential strategies to improve survival and reduce the need for dialysis in similar patient populations.