Study of Clinical Profile of Acute Gastroenteritis Patients with Renal Involvement

Abstract

Background: Acute gastroenteritis (AGE) is one of the most common causes of acute kidney injury (AKI) in developing countries due to volume depletion, electrolyte imbalance and sepsis. Early recognition of renal involvement is crucial to reduce morbidity and mortality.

Aims and Objectives: To study the clinical profile, biochemical parameters, risk factors, and outcome of acute gastroenteritis patients with renal involvement admitted at SAIMS, Indore. Materials and Methods: This was a prospective observational study conducted in the Department of Medicine, Sri Aurobindo Institute of Medical Sciences (SAIMS), Indore, from Jan 2024 to June 2025]. A total of 120 patients aged >18 years presenting with acute gastroenteritis with evidence of renal involvement (raised serum creatinine >1.5 mg/dl from baseline, oliguria <400 ml/day, or AKIN criteria) were included. Detailed history, clinical examination, hydration status, urine output, CBC, RFT, LFT, serum electrolytes, ABG, urine routine and USG KUB were recorded. Patients with pre-existing CKD, obstructive uropathy, nephrotoxic drug intake and chronic diarrheal illness were excluded. Results: Out of 120 patients, 72 (60%) were males and 48 (40%) were females with mean age 42.6 ± 15.2 years. Most common presenting symptoms were vomiting 84%, fever 48%, abdominal pain 32% and decreased urine output 68%. Hypotension at presentation was seen in 52 patients (43.3%). AKI Stage 1 was seen in 58 patients (48.3%), Stage 2 in 36 (30%) and Stage 3 in 26 (21.7%). Most common electrolyte abnormality was hyponatremia (38.3%) followed by hypokalemia (31.6%) and metabolic acidosis (42.5%). Majority responded to fluid resuscitation and conservative management; 18 patients (15%) required hemodialysis. Mortality was 6.6% (8 patients) and was significantly associated with age >60 years, hypotension at admission, and need for dialysis (p<0.05).

Conclusion: Renal involvement is a common and potentially reversible complication of acute gastroenteritis. Hypovolemia-induced pre-renal AKI is the predominant mechanism. Early aggressive fluid resuscitation, correction of electrolytes and timely dialysis can improve outcomes and prevent progression to chronic kidney disease.