A PROSPECTIVE STUDY OF ETIOLOGY, CLINICAL PROFILE AND OUTCOME IN PATIENTS WITH FEVER, JAUNDICE AND ACUTE KIDNEY INJURY AT MEDICINE DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

Dr. Rakesh Kumar, Dr. Rajkamal Choudhary, Dr. Debarshi Jana

Abstract


OBJECTIVE: To study etiology, risk factors, various clinical and lab parameters and outcome of patients presenting with fever, jaundice and
acute kidney injury.
MATERIALS AND METHODS: An open prospective study was done on 100 patients presented with triad of fever, jaundice and acute kidney
injury (AKI) in the Department of Medicine of Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar from September 2018 to
November 2019. Patients having temperature more than >1000 F, serum creatinine ≥1.3 mg/dL or a 50 % increase from baseline or a reduction in
urine output (documented oliguria of <0.5 ml/kg/hr for >6 hours), serum bilirubin >1.8 mg/dL were included in the study. A detailed history,
clinical examination and investigations were done to find the cause of these derangements and all the patients were managed accordingly.
RESULTS: A total 100 patients were included in study out of which 70% were males. Out of 100 patients, 50% were of septicemia, 34% were
having malaria, 12% had acute pancreatitis and 4% patients were of dengue. Out of 50 septicemia patients, 35(70%) were male, out of which
11(31.42%) were of 56-65 years of age. Out of 17 deaths, 13(76%) were males. Among total death, 11(22%) were in septicemia followed by
5(14.70%) in malaria patients.
CONCLUSION: Many infectious and non-infectious diseases like malaria, septicemia, acute pancreatitis, dengue fever etc. can present with
fever, jaundice and deranged renal functions. This triad of presentation is associated with high morbidity and mortality and the advanced age, male
gender presences of anemia were the risk factors for high mortality. AKI occurs most commonly in association with P. falciparum malaria. Early
diagnosis and prompt management including dialysis can reduce mortality and expedite recovery of renal function.


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