11.Vedula R. Aditya Chainulu.cdr INTRODUCTION Acute Kidney Injury (AKI) is a complex condition that manifests in a number of clinical scenarios with it manifestations ranging from modest plasma creat inine escalation to anuric renal failure.It is often under-recognized 1–4and has severe consequences . Recent epidemiological studies show the wide variation in 1,5–7etiology and risk factors , identify the increased mortality associated with this disease (especially when dialysis is 1,4,6,8,9required) , and indicate a relationship to the subsequent development of chronic kidney disease (CKD) and 1,4,8, 10 –12development of dialysis dependence . Emerging evidence suggests that even minor serum creatinine changes are associated with higher in-patient 13–15mortality . Over the past decades, AKI has been the focus of extensive clinical and basic research. A major limitation has been the absence of a universally recognized denition of AKI. Despite signicant progress in understanding the biology and mechanism of AKI in animal models, there has been limited translation of this knowledge into improved patient management and outcomes. Acute Kidney Injury Network (AKIN) is an independent collaborative network of experts selected by the participating societies to represent their eld of expertise as well as their sponsoring organization. AKIN seeks to promote global, interdisciplinary and intersocietal partnerships in order to ensure success in the area of AKI and achieve the best results for patients with or at risk of AKI. AIMS AND OBJECTIVES To study and analyze the etiology of AKI and sepsis as a mortality indicator in AKI patients in ICU. SAMPLE SIZE : 100 INCLUSION CRITERIA : All patients admitted to ICU with AKI and those who developed AKI after admission to ICU. EXCLUSION CRITERIA : Ÿ Patients with pre-existing renal disease and with renal transplant. Ÿ Patients with abnormal kidney size and abnormal cortico- medullary differentiation. RESULTS AND DISCUSSION 100 patients have been analyzed in our research. There were 52 males and 48 females. The mean age was 59.5 years. In the sixth to eighth decade, the highest number of cases were reported. Mehta et al., in her study analysed a sample population which had 59% males and 41% were females with 46mean of 59.5years. Sepsis was found to be the leading cause of Acute Kidney Injury in the current study (40%) as has been time and again proven by multiple studies in the past like Muthusethupathi et 47al in Chennai. This study has shown that among 40 patients with sepsis, 18 patients expired (p<0.001) and sepsis was hence found to be an indicator of higher mortality rates than those without sepsis. Mortality due to septicemia was observed to be 75%. This was identical to the ndings of 48Qutub HO, Saeed IA in their three-year long prospective study (1996 to 1999) in which sepsis emerged as the leading cause of Acute Kidney Injury and also a major contributor for mortality. They also stated that prevention of sepsis would improve the prognosis of patients who got admitted into ICU due to any other cause. 49In another study conducted by Agarwal et al at CMC Vellore in 2004, similar observations were made in pediatric population vis-a-vis septicemia. It was found that mortality due to septicemia was 83% among ICU patients who had Acute Kidney Injury and was a major contributor to morbidity and mortality. Figure 1 : Proportion of cases with sepsis SEPSIS AS A MORTALITY INDICATOR IN ACUTE KIDNEY INJURY PATIENTS IN ICU Original Research Paper Dr . V. R. Aditya Chainulu Junior Resident, Department Of General Medicine, Sree Balaji Medical College And Hospital, Chennai X 29GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS General Medicine Sepsis is an extreme and dysregulated inammatory response to infection that is distant from the primary site of infection resulting in end-organ damage. Appearance of acute kidney injury (AKI) during sepsis raises patient morbidity, predicts higher death rates, has a signicant effect on functions of multiple organs, is associated with a prolonged duration of stay in the intensive care unit, and hence warrants appropriate healthcare resources. Pathophysiology, diagnostic procedures and appropriate therapeutic interventions in sepsis are still highly debatable despite impressive advances in several medical elds. The overwhelmingly high mortality rate of sepsis is not reduced despite multiple immunomodulatory agents showing promise in preclinical studies. Major obstacles to progress in understanding, early diagnosis, and implementing effective therapeutic modalities in sepsis-induced AKI comprise minimal histopathological data, few animal models closely emulating human sepsis, and a relative lack of specialized diagnostic tools. Here we analyse 100 ICU patients who developed AKI and sepsis as a major etiological factor as well as mortality indicator. ABSTRACT KEYWORDS : Sepsis, Acute Kidney Injury, Mortality, Intensive Care Unit, Etiology. VOLUME-9, ISSUE-3, MARCH-2020 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Dr. V. Padma* Professor, Department Of General Medicine, Sree Balaji Medical College And Hospital, Chennai *Corresponding Author Dr. Indhuja Senior Resident, Department Of General Medicine, Sree Balaji Medical College And Hospital, Chennai. 30 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Table 1 : Outcome based analysis of sepsis REFERENCES: 1. 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