ISSN: 2578-4676
Authors: Kallol Bhattacharjee*, Akhil Agrawal and Sanjeeb Roy
Background: AKI is not a disease but rather a clinical syndrome with multiple etiologies as a result of multiple concurrent insults to the kidney and has been defined as a rapid decline in glomerular filtration rate that occurs over a period of minutes to days, with retention of blood urea nitrogen and serum creatinine (SCr). Aims and Objectives: To evaluate the effect of early initiation of RRT versus conservative approach and/or late initiation of RRT on overall mortality and morbidity in cases of AKI. Materials and Methods: The present study was a prospective single-centered, longitudinal, randomized trial conducted in the Department of Medicine at Silchar Medical College and Hospital, Silchar, Assam from 1st July 2016 to 30th June 2019. A total of 150 cases with AKI (KDIGO stage 2 and above) who underwent RRT were included in the study. Results and Observations: Early initiation of RRT significantly reduced duration of renal support, median length of hospital stay. Metabolic abnormalities were more common in patients who received delayed RRT. Also a significantly higher number of patients recovered renal function at day 90 in early group as compared to delayed group. Conclusion: In the management of critically ill patients diagnosed with AKI, initiation of early RRT is beneficial in terms of parameters like mortality, duration of hospital stay, and overall improvement in quality of life when compared with delayed initiation of RRT and/or conservative approach and it comes at a price which is negligible when weighed against the benefits.
Keywords: AKI; Critically Ill; Renal Function; KDIGO Stage; RRT
