Clinical Profile and Factors Associated With Acute Kidney Injury in Critically Ill Patients Admitted to a Tertiary...

Background Acute kidney injury (AKI) is a life-threatening complication among critically ill patients, particularly in resource-limited settings such as Bangladesh, where standardized diagnostic protocols and ICU infrastructure remain inadequate. Evidence on its clinical profile and associated factors in tertiary care ICUs in Bangladesh is scarce. The primary objective of this study was to describe the clinical profile and burden of AKI among critically ill adult patients admitted to a tertiary care ICU in Bangladesh. The secondary objective was to explore clinical and laboratory factors associated with AKI. Methods A prospective observational study was conducted at the ICU of Islami Bank Central Hospital, Dhaka, Bangladesh, from January to December 2024. A total of 70 critically ill adult patients (aged ≥18 years) were enrolled via consecutive sampling. AKI was diagnosed via the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data on sociodemographic characteristics, comorbidities, hemodynamic and laboratory parameters, and clinical interventions were collected via structured data collection sheets. Univariate and multivariate logistic regression analyses were performed via STATA to identify potential factors associated with AKI. A p-value of less than 0.05 was considered statistically significant. Results The overall incidence of AKI was 42 (60.0%). The mean age of the participants was 62.17 ± 17.88 years; 38 (54.3%) were male. Common comorbidities included hypertension in 40 patients (57.1%), diabetes mellitus in 37 patients (52.9%), and chronic kidney disease in 38 patients (54.3%). Sepsis was present in 48 patients (68.6%), and 26 patients (37.1%) developed septic shock. According to multivariate analysis, higher hemoglobin was associated with lower odds of AKI (AOR = 0.49; 95% CI: 0.28-0.85; p = 0.011), whereas hypertension (AOR = 14.02; 95% CI: 2.74-71.87; p = 0.002), septic shock (AOR = 7.68; 95% CI: 1.43-41.21; p = 0.017), and chronic health conditions (AOR = 9.45; 95% CI: 1.86-47.89; p = 0.007) were associated with higher odds of AKI. Conclusions A high burden of AKI was observed among critically ill ICU patients in Bangladesh. Higher hemoglobin levels were associated with lower odds of AKI, whereas hypertension, septic shock and chronic health conditions were associated with higher odds in the exploratory adjusted analysis. Given the limited sample size and exploratory nature of the analysis, these findings should be interpreted cautiously and validated through larger multicenter studies incorporating AKI staging and outcome assessment.