A Prospective Study of Clinical Profile of Patients with Acute Kidney Injury Following Acute Gastroenteritis

Background: Acute gastroenteritis (AGE) is a significant global health burden, particularly in developing nations. Fluid and electrolyte losses from severe diarrhea and vomiting frequently lead to hypovolemia, a primary risk factor for Acute Kidney Injury (AKI). The clinical profile and outcomes of AGE-associated AKI (AGE-AKI) vary considerably. This study aimed to prospectively evaluate the clinical profile, etiological factors, and short-term outcomes of patients presenting with AKI following acute gastroenteritis.

Methods: This prospective observational study was conducted at a tertiary care center over. A total of 84 patients aged >18 years, presenting with a diagnosis of AKI (based on KDIGO criteria) temporally associated with an episode of acute gastroenteritis, were enrolled. Baseline demographic data, clinical features, laboratory parameters (serum creatinine, blood urea, electrolytes, complete blood count), and treatment details were recorded. Patients were followed up until discharge or death to assess renal recovery and mortality.

Results: The mean age of the study cohort was 48.2 ± 16.7 years, with a male predominance (59.5%). The most common presenting symptoms were watery diarrhea (92.8%), vomiting (85.7%), and decreased urine output (73.8%). Pre-renal AKI was the most frequent etiological type (70.2%), followed by intrinsic AKI (23.8%). At presentation, 41.7% of patients had Stage 1 AKI, 35.7% had Stage 2, and 22.6% had Stage 3. Electrolyte imbalances were common, with hyponatremia (45.2%) and hyperkalemia (33.3%) being the most prevalent. The majority of patients (76.2%) were managed with intravenous fluid resuscitation alone, while 23.8% required renal replacement therapy (RRT). Complete renal recovery was observed in 70 (83.3%) patients. In-hospital mortality was 8.3% (n=7). Need for RRT, severity of AKI at presentation, and presence of sepsis were independent predictors of poor outcomes.

Conclusion: AGE-AKI predominantly affects middle-aged males and is largely driven by pre-renal factors. Prompt fluid resuscitation leads to favorable outcomes in the majority. However, a significant proportion still progress to severe AKI requiring RRT, with associated high mortality. Early recognition and aggressive management of hypovolemia are crucial to mitigate the burden of this condition.