Incidence and Clinical Outcomes of Acute Kidney Injury among Mechanically Ventilated Patients in a Tertiary Care Hospital: A Prospective Observational Study

Abstract

Introduction: Acute kidney injury (AKI) is a common and clinically important condition in critically ill patients, particularly those requiring invasive mechanical ventilation. Mechanical ventilation can contribute to the development of AKI by increasing intrathoracic pressure, reducing venous return and cardiac output, altering renal perfusion, and increasing renal venous congestion. Early recognition of AKI in mechanically ventilated patients is essential for timely preventive measures and improving patient outcomes. Methods: A prospective observational hospital-based study was conducted from April to June 2026 among 108 mechanically ventilated adults. Consecutive sampling was used, with AKI diagnosed and staged according to Kidney Disease: Improving Global Outcomes 2012 criteria. Demographic and laboratory parameters were monitored daily. Outcomes were hospital discharge or death. Continuous and categorical variables were appropriately analyzed using parametric and non-parametric tests. Results: Among 108 mechanically ventilated patients, 40.7% developed AKI, with Stage 3 being most common. AKI patients had significantly higher blood urea nitrogen (BUN) and lower urine output. Mortality was higher in AKI patients (45.5% vs. 35.9%), but the difference was not statistically significant. Conclusion: Close monitoring for AKI is important in mechanically ventilated patients. Regular monitoring of urine output, serum creatinine and BUN is important for early detection of AKI and appropriate management.