Spectrum and Outcomes in Patients with Skin and Subcutaneous Tissue Infections and Severe Renal Dysfunction

Abstract

Introduction: Skin and soft tissue infections (SSTI) encompass a variety of conditions that account for a large percentage of infections requiring hospitalization, and are associated with high morbidity.The incidence of necrotizing fasciitis ranges from 0.3 to 15 cases per 100,000 population. Sepsis, drug related like antibiotics and NSAIDS, hypotension and, less commonly, infection-related glomerulonephritis are few of the various causes of AKI in SSTI. Methods: This is a retrospective observational study done in a tertiary care hospital over a period of 1 year which included patients with SSTI and renal dysfunction. Results: A total of 100 patients were studied, of which 69 were male and 31 were female. Mean age was 51.59 ± 13.04 years. Limb swelling (78%) is the most common manifestation followed by redness (73%). Oliguria was observed in 52% of the patients. Diabetes was observed in 56% of them and baseline CKD was noted in 54% of the patients. In our study, 20% of the patients were managed conservatively whereas 80% underwent RRT of which 65% underwent hemodialysis and 15% underwent peritoneal dialysis. Mortality in our study was found to be 27%. It was noted that low albumin, low hemoglobin and the need for RRT were found to be major factors influencing mortality. Conclusions: The presence of severe renal dysfunction in SSTI patients significantly increases the risk of adverse outcomes, the need for renal replacement therapy, and higher mortality rates but this cannot be generalized as study population is limited to those with renal dysfunction.