الفهرس 
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Abstract
CA-AKI is a major public health problem with increasing incidence world-wide. AKI is divided into two types: CA-AKI and HA-AKI. CA-AKI occurs when a patient’s serum creatinine is increased at the time of presentation to the hospital, and the rise occurred outside of the hospital, while HA-AKI occurs when a patient’s serum creatinine increases 24 hours or more after hospitalization.
This is a single-center prospective observational study, where the clinical characteristics, risk factors, associated comorbidities, and outcomes of CA-AKI were evaluated among patients admitted to Alexandria Main University Hospital (AMUH) over a 12-week period.
This study included 212 patients presenting with CA-AKI, which represents 1.86% of patients admitted to AMUH during this period (11426 patients).
Hypertension, DM and CKD were the most commonly associated comorbidities. Renal causes were the most common cause of AKI in 146 patients, pre-renal in 93 patients and post-renal in 50 patients. Specifically, sepsis-associated acute kidney injury and hypovolemia were the most common etiologies. One hundred-eighty-five (185) patients (87.3%) were stage 3 according to KDIGO criteria, 19 patients (9%) were stage 2, and 8 patients (3.8%) were stage 1.
Roughly a third of the afflicted patients died, while renal recovery occurred in the majority of CA-AKI cases with variable rates of partial and complete recovery. Long hospital stay (P=0.001*) and the presence of acute interstitial nephritis (P=0.016*) were among risk factors for in-hospital mortality of CA-AKI cases in both univariate and multivariate analysis, while serum pH level was significantly associated with CA-AKI in univariate analysis (P= 0.044*), but not in multivariate analysis.
Fifty-three (53) patients (25%) required hemodialysis (HD); uremia was the most common indication in 29 patients (54.7%). Six patients (11.3%) were dialysis dependent upon discharge.