A Hospital-Based Study on the Clinical and Demographic Profile of Hemodialysis at a Tertiary Care Institute

Abstract

Background: Hemodialysis (HD) is a vital intervention in the intensive care unit (ICU), particularly for patients with acute kidney injury (AKI), chronic kidney disease (CKD), or end-stage renal disease (ESRD) with superimposed complications.

Aim: This study aims to evaluate the clinical characteristics, causes of AKI, dialysis modalities, complications, and outcomes in ICU patients undergoing hemodialysis.
Methods: A retrospective analysis was conducted at Father Muller Medical College from January 2018 to December 2023. Medical records of 1245 patients who underwent hemodialysis in the ICU were reviewed. Data on demographics, comorbidities, laboratory parameters, dialysis modality, vascular access, complications, and outcomes were analyzed.
Results: The mean age of patients was 36.7 ± 14.5 years, with a slight male predominance (50.3%). Hypovolemia (22.5%), acute glomerulonephritis (21.9%), and pregnancy-related complications (18.5%) were the leading causes of dialysis-requiring AKI. Of the total, 16.9% had AKI superimposed on CKD, primarily due to hypertension. Intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) were used based on hemodynamic status. The most common indication for dialysis was refractory fluid overload (89.4%). Complications included hemodynamic instability, infections, bleeding, and electrolyte imbalances. Overall mortality was 29.1%, while 53% were discharged improved.
Conclusion: Hemodialysis in the ICU is associated with significant morbidity and mortality. Tailored dialysis modality selection, early identification of AKI causes, and optimized vascular access strategies are crucial for improving patient outcomes.