# Occurrence and Clinical Outcomes of Acute Kidney Injury (AKI) Secondary to Acute Pyelonephritis in Hospitalized Patients at Dubai Health Facilities: A Retrospective Study

## TL;DR

This study examines how often acute kidney injury occurs in hospitalized patients with acute pyelonephritis in Dubai and identifies risk factors and outcomes.

## Contribution

The study provides new insights into AKI incidence and outcomes specifically in acute pyelonephritis patients in Dubai's healthcare setting.

## Key findings

- AKI occurred in a notable percentage of hospitalized acute pyelonephritis patients.
- Positive blood culture and pre-existing CKD were significant risk factors for AKI.
- Most patients with AKI experienced complete recovery, while a minority progressed to CKD.

## Abstract

Acute Kidney Injury (AKI) is a rare but significant complication associated with acute pyelonephritis, which, if left untreated, can cause severe renal impairment, thereby affecting renal structure and function.

Upon reviewing the literature, we found that there are limited studies published on the outcomes of acute pyelonephritis. Our study, therefore, aims to evaluate the incidence and clinical outcomes of AKI in patients hospitalized with acute pyelonephritis at tertiary care hospitals under the 'Dubai Health' Institution.

We reviewed the medical health records of patients, noting details such as demographic data, risk factors, and vital signs. Out of 303 patients who were hospitalized with acute pyelonephritis, a marked percentage of patients developed AKI. The incidence of acute pyelonephritis (APN) was higher in the female population than in males; however, the incidence of AKI was higher in males than in females, with a median age of 41 years. A strong association between having a positive blood culture and the development of AKI was noted, thereby denoting the fact that patients with bacteremia were more susceptible to AKI. Chronic kidney disease (CKD), current or recent urinary tract catheterization, and emphysematous pyelonephritis were found to be the commonest risk factors for the development of AKI. Outcomes showed that a significant percentage of patients experienced complete resolution of AKI, a minority progressed to CKD, and perhaps only a small percentage succumbed to the illness.

AKI is a serious but potentially reversible complication of acute pyelonephritis that requires early recognition and prompt management to prevent long-term renal failure. The Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria serve as a valuable tool in guiding treatment decisions, particularly regarding the need for renal replacement therapy. Older age, male gender, bilateral involvement, and pre-existing CKD were identified as key risk factors, emphasizing the need for close monitoring and timely antibiotic and supportive therapy in these patients.