Pt. Jawaharlal Nehru Memorial medical College, India
Title: Severity of Acute Kidney Injury by different score methods in patients admitted in Tertiary Care Hospital. A study from developing Country
Professor Dr. Punit Gupta is MBBS, MD (Medicine), DM (Nephrology) and PhD. He is the Honorary Nephrologists to the Governor of Chhattisgarh State since 2009. He is Chairman and Members of many important academic and management committees of various Government Medical Institutions in the country and the Pt. Deen Dayal Upadhyay Health Sciences University, Raipur.He has guided over 100 Postgraduate & Technologist student for their thesis & Project in Nephrology & Research and also severed as an examiner for the university examinations.A man of researches and publication, he has presented more than 160 research papers and abstracts on Kidney Diseases in Tribal populations at Renowned National and International Conferences. He was felicitated for being the only research scholar who had presented 29 abstracts in Indian Society of Nephrology conference, Pune and 11 research papers at Asia Pacific congress of Nephrology, 2008 in Malaysia on tribal kidney diseases.His Oral Paper was awarded first prize in ISNCON 2007, New Delhi. He was awarded internationally prestigious APCN Developmental awards in Malaysia 2008 and a Follow Scholarship by International Society of Peritoneal Dialysis in Turkey 2008. His paper was recognized as a best Paper in API 2014, Bhilai. He was awarded Certificate of Excellence awards by the Times of India groups 2016. His work was appreciated with certificate of appreciation by Indian Dietician association 2016. He was felicitated by Agrasen Agrawal Samaj for his excellent work in Tribal Population 2016. He was honoured with excellence award by ‘Z’ TV Chhattisgarh for this distinguish work in kidney disease in rural population of Chhattisgarh in 2017. He has developed a concept of Teledialysis, first of its kind in Asia.He has developed Portable dialysis Machine (MAKE-D) for 60 billion kidney patients in world who require dialysis many times in a week. He has developed an abdominal Pressure Measurement Scale, which is very useful of Continuous Ambulatory Peritoneal Dialysis Patients (type of dialysis). He has developed and economic, efficient and effective walkie talkie system for consultation and directions to the hospital staff and doctors. He has been awarded Dr. B. C. Roy National Award for his research to give Aid or Assistance to Research Project for the year 2016.
Introduction: Gastroenteritis is an important cause of acute Kidney Injury. It was reported that gastroenteritis as a cause of Acute Kidney Injury in 22-44.5% of the cases. The severity of illness was assessed using Glassgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA) score;Multiorgan dysfunction scores (MODS). These scales and scores help in assessing prognosis and outcome of the patients in study.
Method: The study was conducted in the Department of Nephrology, Pt. J.N.M. Medical College and Dr. B.R.A.M.Hospital, Raipur. 50 patients of Acute Kidney Injury were included for the purpose of study suffering from Acute Gastroenteritis admitted in Nephrology Unit, Pt.J.N.M.Medical College Raipur from was studied by MODS,SOFA and CGS SCORE in Acute Kidney Injury All patients were subjected to routine investigations.
Results: Acute Gastroenteritis associated AKI includes 87.5% males, 12.5% Females. AKI most commonly seen in people of age group 41-50 (62.5%). 68.75% patients presented with features of AKI in first 3 days. CGS score deranged in 50% patients affected by AGE with AKI. MODS score is deranged in 100% of patients suffering fromAGE with AKI. SOFA score is deranged in 100% of patients suffering fromAGE with AKI. Survival rate among patients suffering from AKI associated with AGE is 81.25% while mortality is 18.75%. 50% had Multiorgan dysfunction and among them the mortality was 25% . Mortality is 100% in patients having CGS score 7-11 & 11-13 & no mortality reported in <7 OR >13 GCS score groups suffering from AGE with AKI. Mortality rate of patients having MOD score 9-16 & 5-8 is 100% & 20% respectively and No mortality reported in 0-4 suffering from AGE with AKI. Mortality rate of patients having SOFA score 9-16 & 5-8 is 100% & 16.67% respectively and No mortality reported in 0-4 suffering from AGE with AKI. 43.75% required No.of dialysis is 2 ,more than 4 times dialysis required in 18.75% mean dialysis requirement is 2.75±1.5. 12.5% patients require ventilatory support. Mean days of hospitalization was 9.9±3.6 days.
Conclusion: AGE with Acute Kidney injury was more common in male as compared to female. AKI most commonly seen in people of age group 41-50. Maximum number of patients presented with features of AKI in first 3 days. MODS score is deranged in all patients suffering from AGE with AKI. SOFA score is deranged in all of patients suffering from AGE with AKI. Multi-organ dysfunction seen in half of the patient suffering from AGE with AKI. Mortality of patient having MOD is 25%. 100% mortality seen with CGS 7-11 and 11-13. Maximum dialysis sessions required was 4. 90% survival for AKI with AGE on hemodialysis