Background: Acute Kidney Injury (AKI) is acknowledged as a major and common complication in patients presenting with Acute ST-Elevation Myocardial Infarction (STEMI). Renal impairment in these patients is frequently due to an interplay between decreased cardiac output, kidney hypoperfusion, exposure to contrast media, and systemic inflammation. AKI enhances short-term morbidity and deteriorates long-term outcomes, such as mortality and readmission rates.

Purpose: To determine the frequency of Acute Kidney Injury among patients presenting with Acute ST-Elevation Myocardial Infarction in a tertiary cardiac care unit.

Methods: An observational, cross-sectional study was conducted at the Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) between August 2024 and April 2025. The study included 100 patients diagnosed with Acute STEMI. Patients with pre-existing chronic kidney disease or prior contrast exposure were excluded. Serum creatinine levels were measured at admission and 48–72 hours post-intervention. AKI was defined using the KDIGO criteria. Data were statistically analyzed using SPSS version 26.

Results: Of the 100 patients, 28 (28%) developed Acute Kidney Injury during hospitalization. The mean age of patients was 58.4 years, with a male predominance (72%). AKI development was significantly related to hypertension ($p = 0.03$), diabetes mellitus ($p = 0.01$), and higher admission Killip class ($p < 0.01$). In-hospital mortality was significantly higher in AKI patients compared to non-AKI patients (25% vs. 4.2%, $p = 0.004$). Patients with AKI also experienced longer hospital stays.

Conclusion: The occurrence of Acute Kidney Injury in patients presenting with STEMI is significant. Advanced age, diabetes mellitus, hypertension, and elevated Killip class were identified as key risk factors. Early identification and renal protection measures are essential to minimize complications and improve clinical outcomes.

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