Background: Acute kidney injury (AKI) is common across hospital settings and is associated with significant morbidity and mortality. Its etiological spectrum varies widely by region, and short-term outcome depends on the underlying cause and severity of renal and metabolic derangement.

Objective: To determine the common etiologies of AKI, evaluate outcome according to etiology, and identify parameters predicting short-term outcome in a tertiary care setting.

Methods: This observational, descriptive, single-centre study was conducted in the Department of General Medicine, IPGME&R and SSKM Hospital, from May 2023 to April 2024. Inpatients aged 13 years or above with clinical and/or biochemical evidence of AKI were included; patients with diabetes mellitus or chronic kidney disease were excluded. A sample of 100 patients was selected by weekly randomisation and followed for 7 days for symptom evolution, investigation trends, and outcome. Categorical variables were compared using the chi-square test and continuous variables using the t-test or rank-sum test, as appropriate, with SPSS v24.

Results: Of 100 patients, 52% were male, with a mean age of 40.6 years overall. Oliguria was the most common presenting feature (71%). Acute gastroenteritis (28%), snakebite (16%), and sepsis (15%) were the leading etiologies, together accounting for 59% of cases. Renal/intrinsic AKI was the most common type (62%), followed by prerenal (28%) and postrenal (10%) causes. Hemodialysis was required in 51% of patients. At 1 week, 67% had fully recovered, 19% partially recovered, and 14% died; sepsis accounted for 42.9% of deaths. Higher serum urea, creatinine, and potassium levels, and requirement of renal replacement therapy, were each significantly associated with poorer outcome (p<0.05).

Conclusion: Acute gastroenteritis, snakebite, and sepsis were the leading causes of AKI in this cohort. Serum urea, creatinine, and potassium levels, along with the need for renal replacement therapy, were significant predictors of short term outcome, supporting their use in early risk stratification of AKI patients.

KEYWORDS: Acute Kidney Injury, Etiology, Outcome, Hemodialysis, Renal Replacement Therapy.