DOI: https://doi.org/10.36347/sjams.2026.v14i03.016

Pages: 413-421

Background: Acute Kidney Injury (AKI) is a significant public health concern with high morbidity and mortality, yet data on its etiology and outcomes in resource-limited settings remain scarce. The ISN 0by25 protocol provides a standardized framework for AKI research in such contexts. Objective: To determine the etiology and outcomes of AKI in a tertiary care hospital in Bangladesh using the ISN 0by25 protocol. Methods: This observational longitudinal study was conducted at the National Institute of Kidney Disease and Urology (NIKDU), Dhaka, from June 2018 to July 2019. A total of 304 adult patients with confirmed AKI were enrolled using purposive sampling. Data were analyzed using SPSS version 23, with chi-square tests used to determine associations. Results: The mean age was 43.8 ±16.2 years, with a slight female predominance (51%). Pre-renal AKI was most common (60.2%), and 72.7% presented with Stage 3 AKI. Sepsis (21.1%) and diarrhea (20.4%) were the leading individual etiologies. At seven days, 35.2% achieved complete recovery, 34.5% partial recovery, 21.1% had no recovery, and 9.2% expired. Sepsis was the predominant cause among non-survivors (p<0.001), while diarrhea was associated with complete recovery (p<0.001). Acute glomerulonephritis or vasculitis was linked to non-recovery (p<0.001). Conclusion: AKI in this tertiary care setting presents with distinct etiologies and prognostic patterns. Sepsis carries the highest mortality, diarrhea-associated AKI has excellent recovery potential, and acute GN or vasculitis portends poor renal recovery. These findings highlight the need for etiology-specific prevention and management strategies.