Clinical Presentation and Outcome of Acute Kidney Injury at a Tertiary Care Hospital in Bangladesh: A Retrospective Study

Background: Acute kidney injury (AKI) is a frequent condition and its incidence is increasing. Early identification of precipitating factors and timely management are essential to improve outcomes, particularly in resource-limited healthcare settings. Objective: The purpose of this retrospective study was to evaluate the demographic and clinical characteristics, etiological factors, investigation findings, treatment modalities, and short-term in-hospital outcomes of adult patients with acute kidney injury (AKI) admitted to a tertiary-care hospital in Bangladesh. Methods: This retrospective observational study was conducted in the Department of Nephrology, Bangladesh Medical University (BMU) Hospital, Dhaka, Bangladesh, over a two-year period from August 2024 to July 2026. A total of 100 patients with AKI were included in this study according to selection criteria. Patients with pre-existing chronic kidney disease or having malignancy/pregnancy were excluded. AKI was defined according to the kidney disease: Improving Global Outcomes (KDIGO) criteria. Demographic characteristics, clinical presentations, underlying diagnoses, treatment modalities, requirement for renal replacement therapy and outcomes at discharge were recorded from hospital records. Outcomes were categorized as recovery with preserved renal function, persistent renal dysfunction at discharge, or in-hospital death. Results: The mean age of the patients was 38.52 ± 11.52 years, and 58% were male. Oliguria and oedema were the most frequent clinical presentations, each occurring in 67% of patients, followed by shortness of breath (32%) and diarrhea (24%). Hypovolemia was the leading cause of AKI (24%), followed by NSAID exposure (21%) and rhabdomyolysis (10%). Proteinuria (42%), urinary WBCs (40%), and granular casts (37%) were common urine abnormalities. Serum creatinine >6.8 mg/dL was observed in 70% of patients, blood urea >180 mg/dL in 55%, and pulmonary oedema on chest radiography in 49%. Fluid therapy was administered to 85% of patients, pharmacological treatment to 42% and hemodialysis was required in 12% patients. At discharge, 67% recovered with preserved renal function, 23% had persistent renal dysfunction, and 10% died during hospitalization. Conclusion: In this cohort, AKI was predominantly associated with potentially preventable factors, particularly hypovolemia and NSAID exposure. Although two-thirds of patients recovered with preserved renal function, a considerable proportion developed persistent renal dysfunction or died.