Incidence of conversion of AKI to CKD: A retrospective study in a tertiary care hospital

Abstract

Background: Acute Kidney Injury (AKI) is characterized by an abrupt decrease in kidney function, posing a substantial clinical challenge worldwide. AKI often results in adverse outcomes including progression to chronic kidney disease (CKD), which increases long-term morbidity, healthcare costs, and mortality. Understanding factors influencing this progression is critical to improving patient care and preventing chronic renal impairment.

Aim: This study aimed to determine the incidence of progression from AKI to CKD among hospitalized patients and identify key risk factors, emphasizing the role of appropriate and timely antibiotic use in AKI caused by infections.

Methods: A retrospective cohort study was performed at a tertiary care hospital, enrolling 200 patients diagnosed with AKI. Data on demographics, AKI severity, etiologies, and outcomes were collected. CKD conversion was defined as sustained reduction of GFR below 60 mL/min/1.73 m² beyond 3 months post-AKI. Statistical analyses included Kaplan-Meier survival curves and Cox regression to evaluate progression risks.

Results: Out of 200 patients, 40 (20%) progressed to CKD. CKD incidence correlated with AKI severity: 8.2% in Stage 1, 20.6% in Stage 2, and 52.9% in Stage 3 (p < 0.001). Intrinsic renal AKI showed the highest progression (39.5%). Timely interventions, particularly appropriate antibiotic administration in infection-related AKI, significantly reduced progression to 13.2%.

Conclusion: AKI severity and cause strongly influence CKD development. Early, cause-specific treatment—especially judicious antibiotic use—is vital to prevent long-term renal damage and improve prognosis.

Keywords: Acute Kidney Injury, Chronic Kidney Disease, Antibiotic Therapy, Renal Outcomes, AKI Progression