https://doi.org/10.4081/acbr.2022.230

Aetiological factors, outcomes and mortality risk of acute kidney injury in hospitalized patients in a tertiary health centre in Nigeria: An eleven year review

Vol. 3 No. 2 (2022)
Submitted: 7 July 2022
Accepted: 1 September 2022
Published: 22 September 2022
Acute kidney injury aetiologies, outcome, risk factors for mortality
Abstract Views: 465
PDF: 202
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Authors

Manmak Mamven
manmakm@yahoo.com
https://orcid.org/0000-0003-3229-6689
Department of Medicine, College of Health Sciences, University of Abuja; Department of Medicine, University of Abuja Teaching Hospital Gwagwalada, Nigeria.
Samuel Ajayi
https://orcid.org/0000-0003-4395-9222
Department of Medicine, College of Medicine, University of Ibadan, Nigeria.
Usman Galadima
https://orcid.org/0000-0002-0273-5380
Department of Medicine, University of Abuja Teaching Hospital Gwagwalada, Nigeria.
Emeka Nwankwo
Department of Medicine, College of Health Sciences, University of Abuja; Department of Medicine, University of Abuja Teaching Hospital Gwagwalada, Nigeria.

Acute kidney injury is a major public health issue in Nigeria, and it is associated with an increase in mortality. The study’s goal was to look at the most common precipitating factors, outcomes, and risk factors associated with mortality in our patients. This study examined the medical records of 11 years, of of hospitalized adult patients with confirmed Acute Kidney Injury (AKI). The patient record was searched for relevant information. The Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria were used to define AKI. The logistic regression analysis was used to determine the risk factors associated with mortality. A total of 399 patients were analysed. The overall mean age was 45.0 ± 17.3. The older age group (≥ 60years) compared to the younger group (<60 years) developed hospital acquired AKI (10% vs 5%). Pre-existing diseases like, hypertension (p<0.001), diabetes mellitus (p<0.001), anemia (p<0.001), stroke (p<0.001) and malignancy (p<0.001) were significantly higher in the older group. More of the older age group had more than 1 comorbidity (66 vs. 48%), were on diuretic and ACEI. The commonest causes/precipitants of AKI were septicaemia and other infections (62%) and hypovolaemia/hypoperfusion (45%). Overall mortality was 34%. The median length of stay was 11 (7.20) days, 25% had hemodialysis and 16% were admitted in the ICU. The risk factors for mortality identified were, hospital acquired AKI (OR: 6.59, 95% CI: 1.320-32.889, p=0.021), ICU admission (OR: 5.66, 95% CI: 2.061–15.512, p=0.001) and HIV infection (OR: 2.61, 95% CI: 1.063-6.424, p=0.036). The Commonest causes of AKI still remain infections and hypovolaemia and mortality from it was high in our patient population. Early identification of AKI and those at high risk of mortality and provision of adequate treatment are critical to improving outcomes in AKI patients.

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Crossref
Scopus
Google Scholar
Europe PMC
Feehally J. The ISN 0by25 Global Snapshot Study. Ann Nutrition Metabolism 2016;68:29-31. DOI: https://doi.org/10.1159/000446202
Lewington AJ, Cerda J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int 2013;84:457-67. DOI: https://doi.org/10.1038/ki.2013.153
Oluseyi A, Ayodeji A, Ayodeji F. Aetiologies and Short-term Outcomes of Acute Kidney Injury in a Tertiary Centre in Southwest Nigeria. Ethiopian J Health Sci 2016;26:37-44. DOI: https://doi.org/10.4314/ejhs.v26i1.8
Effa EE, Okpa HO, Epoke E, et al. Acute kidney injury in hospitalized patients at the university of calabar teaching hospital: An aetiological and outcome study. IOSR J Dent Med Sci 2015;14:55–59.
Olowu WA, Niang A, Osafo C, et al. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review. Lancet Glob Health 2016;4:e242-50. DOI: https://doi.org/10.1016/S2214-109X(15)00322-8
Ponce D, Balbi A. Acute kidney injury: risk factors and management challenges in developing countries. Int J Nephrol Renovasc Dis 2016;9:193-200. DOI: https://doi.org/10.2147/IJNRD.S104209
Okoye O, Mamven M. Peri-surgical acute kidney injury in two nigerian tertiary hospitals: a retrospective study. West Afr J Med 2020;37:396-401.
Okunola OO, Ayodele OE, Adekanle AD. Acute kidney injury requiring hemodialysis in the tropics. Saudi J Kidney Dis Transpl 2012;23:1315-9.
Muhammad M, Liman H, Yakubu A, et al. Clinical pattern and outcome of acute kidney injury patients from a Tertiary Health Institution in Northwestern Nigeria. Sahel Medical J 2016;19:142. DOI: https://doi.org/10.4103/1118-8561.192399
Cerda J, Bagga A, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nat Clin Pract Nephrol 2008;4:138-53. DOI: https://doi.org/10.1038/ncpneph0722
Makusidi M, Liman H, Yakubu A, et al. Hemodialysis among pregnancy related acute kidney injury patients: A single center experience in North-Western Nigeria. Indian J Nephrol 2016;26:340. DOI: https://doi.org/10.4103/0971-4065.171224
Halle MPE, Chipekam NM, Beyiha G, et al. Incidence, characteristics and prognosis of acute kidney injury in Cameroon: a prospective study at the Douala General Hospital. Ren Fail 2018;40:30-7. DOI: https://doi.org/10.1080/0886022X.2017.1419970
Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005;16:3365-70. DOI: https://doi.org/10.1681/ASN.2004090740
Susantitaphong P, Cruz DN, Cerda J, et al. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol 2013;8:1482-93. DOI: https://doi.org/10.2215/CJN.00710113
Mehta RL, Cerda J, Burdmann EA, et al. International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 2015;385:2616-43. DOI: https://doi.org/10.1016/S0140-6736(15)60126-X
Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clinical Practice 2012;120:c179-c84. DOI: https://doi.org/10.1159/000339789
Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-6. DOI: https://doi.org/10.1097/01.CCM.0000050454.01978.3B
Forni LG, Darmon M, Ostermann M, et al. Renal recovery after acute kidney injury. Intensive Care Med 2017;43:855-66. DOI: https://doi.org/10.1007/s00134-017-4809-x
Emem-Chioma PC, Alasia DD, Wokoma FS. Clinical outcomes of dialysis-treated acute kidney injury patients at the university of port harcourt teaching hospital, Nigeria. ISRN Nephrol 2012;2013:540526. DOI: https://doi.org/10.5402/2013/540526
Bagasha P, Nakwagala F, Kwizera A, et al. Acute kidney injury among adult patients with sepsis in a low-income country: clinical patterns and short-term outcomes. BMC Nephrol 2015;16:4. DOI: https://doi.org/10.1186/1471-2369-16-4
Onah MN, Govender V. Out-of-pocket payments, health care access and utilisation in south-eastern Nigeria: a gender perspective. PLoS One 2014;9:e93887. DOI: https://doi.org/10.1371/journal.pone.0093887
Xu X, Nie S, Liu Z, et al. Epidemiology and clinical correlates of AKI in Chinese hospitalized adults. Clin J Am Soc Nephrol 2015;10:1510-8. DOI: https://doi.org/10.2215/CJN.02140215
Yang L. Acute kidney injury in asia. Kidney diseases (Basel, Switzerland) 2016;2:95-102. DOI: https://doi.org/10.1159/000441887
Petejova N, Martinek A, Zadrazil J, Teplan V. Acute toxic kidney injury. Renal Failure 2019;41:576-94. DOI: https://doi.org/10.1080/0886022X.2019.1628780
Kaballo BG, Khogali MS, Khalifa EH, et al. Patterns of "severe acute renal failure" in a referral center in Sudan: excluding intensive care and major surgery patients. Saudi J Kidney Dis Transpl 2007;18:220-5.
Wyatt CM, Arons RR, Klotman PE, Klotman ME. Acute renal failure in hospitalized patients with HIV: risk factors and impact on in-hospital mortality. AIDS 2006;20:561-5. DOI: https://doi.org/10.1097/01.aids.0000210610.52836.07
Peres L, Wandeur V, Matsuo T. Predictors of acute kidney injury and mortality in an Intensive Care Unit. Jornal Brasileiro de Nefrologia 2015;37:38-46. DOI: https://doi.org/10.5935/0101-2800.20150007
Melo FAF, Macedo E, Fonseca Bezerra AC, et al. A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries. PLoS One 2020;15:e0226325. DOI: https://doi.org/10.1371/journal.pone.0226325

How to Cite

Mamven, M., Ajayi, S., Galadima, U., & Nwankwo, E. (2022). Aetiological factors, outcomes and mortality risk of acute kidney injury in hospitalized patients in a tertiary health centre in Nigeria: An eleven year review. Annals of Clinical and Biomedical Research, 3(2). https://doi.org/10.4081/acbr.2022.230

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