Acute renal failure in diabetes mellitus

ABSTRACT

To study the causes and outcome of Acute renal failure [ARF] in diabetes mellitus. This prospective study was conducted at nephrology unit of SIUT Karachi, Pakistan from November 2012 to May 2013. All adult patients with known underlying diabetes presenting with suspected ARF were included in the study. The treatment options were conservative and dialysis. Renal biopsy was performed in selected patients. All patients were followed for a period of six weeks for outcome of renal failure i.e. recovery, dialysis dependency and death. A total of 95 patients with suspected ARF were enrolled during this period. We found sepsis as the single most common factor causing ARF in 66 [69.5%] patients and the most common focus of infection was found to be urinary tract in 47 [71.2%] patients. Other factors leading to ARF included volume depletion in 19 [20%], cardio renal in 13 [13.7%], acute glomerulonephritis in 3 [3.15%] and contrast exposure in 2 [2.1%] patients. In all 72 [75.8%] patients required dialysis, while 23 [24.2%] were managed conservatively. Eventually 62 [67.39%] patients recovered, 14 [15.21%] became dialysis dependent, and 16 [17.39%] died. Among those who expired, all underwent dialysis and sepsis was the leading cause of death in 13 [81.25%] patients. Infection, especially of urinary tract is the leading cause of ARF in Diabetics. Outcome is favourable in those who dot require dialysis