A Comparative Study of Community- and Hospital-Acquired Acute Kidney Injury in a Tertiary Care Hospital in Balochistan

Abstract

Objective: To compare the incidence, risk factors, and outcomes of community-acquired acute kidney injury and hospital-acquired acute kidney injury.
Study Design: Prospective comparative study.
Place and Duration of Study: This study was conducted at the Department of Nephrology, Combined Military Hospital (CMH), Quetta, Pakistan from January 2023 to June 2024.
Methods: Patients diagnosed with renal injury were classified as community-acquired acute kidney injury if onset occurred before hospital admission and as hospital-acquired acute kidney injury if onset occurred postadmission. Data collected included demographic information, underlying comorbidities, laboratory values, and details of treatments received. Statistical analysis compared incidence rates, risk factors, and patient outcomes, including mortality rates and requirements for renal replacement therapy.
Results: Out of 33 patients, 27 (81.8%) had community-acquired acute kidney injury, while 6 (18.2%) had hospital-acquired acute kidney injury. Most admissions were from the medical unit (87.9%), with fewer from surgical (9.1%) and obstetric (3%) units. The cohort had a mean age of 45.58 ± 18.03 years, and the majority were male (63.6%). In terms of acute kidney injury severity, 51.5% of patients were classified as Kidney Disease Improving Global Outcomes stage 3, 33.3% as stage 1, and 15.2% as stage 2. Complications included oliguria in 18.2%, hyperkalemia in 12.1%, and metabolic acidosis in 12.1% of patients. Vasopressor support was required in 24.2%, mechanical ventilation in 12.1%, and dialysis in 30.3%. Among community-acquired acute kidney
injury patients, 22.2% received vasopressors and 25.9% required dialysis; survival was 92.5%, with 7.4% mortality. All hospital-acquired acute kidney injury patients survived, with 33.3% on vasopressors and 50% on dialysis.
Conclusion: Acute Kidney Injury is common among hospitalized patients, with significant in-hospital mortality. Most cases are community-acquired. These emphasize the need for targeted interventions in hospital settings to prevent acute kidney injury and to enhance early identification and management strategies to reduce its incidence.

How to cite this: Khan Z, Malik MH, Liaqut R, Altaf A, Anum H, A Comparative Study of Community- and Hospital-Acquired Acute Kidney
Injury in a Tertiary Care Hospital in Balochistan. Life and Science. 2026; 7(3): 411-416. doi: http://doi.org/10.37185/LnS.1.1.881