Clinical characteristics and outcomes of patients with dialysis requiring AKI at the Tikur Anbessa specialized hospital.
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Date
2019-11
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Addis Abeba University
Abstract
Background:
Acute kidney injury (AKI) in developing countries is the disease of the young and children while
developed countries elderly patients with co morbid conditions predominate. The management of
patients with acute kidney injury (AKI) is supportive, with renal replacement therapy (RRT)
indicated in patients with severe kidney injury.
Even though, government run dialysis service is given in few centers in Ethiopia, data on
epidemiological and clinical characteristics of dialysis requiring AKI patients and its outcome is
sparse.
Objectives:
The objective of this study is to describe socio-demographic, clinical characteristics of patients
with dialysis requiring AKI and their renal and hospital outcome at Tikur Anbessa Specialized
Hospital, Addis Ababa, Ethiopia.
Methods:
The study is an institution based retrospective chart review of patients with AKI who were
hospitalized and had hemodialysis inTikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
from July 14, 2016 to September 2019. Data on socio-demographic characteristics, clinical
profiles, and dialysis and hospital outcomes were collected using a structured questionnaire. Data
entry and analysis was done on (SPSS) version 20. Frequency tables and odds ratio was used to
explain and analyze the results. Factors found to be significantly associated with mortality on
bivariate analysis (P-value< 0.05) were analyzed with a multivariate model using logistic
regression to determine the predictors of in-hospital mortality. P values less than 0.05 were
considered statistically significant.
Result
A total 275 patients underwent hemodialyis during the period, of which 130 patients, 71 females
(54.6%) and 59 males(45.6%), with a median age of 34 were included in the study. The most
common causes of AKI were sepsis (33.8%), glomerulonephritis(31.5%) and pregnancy related causes (16.2%). A quarter of the patients (25.4%) did require ICU admission. The in hospital
mortality was 26.2%. Sepsis, co morbid heart failure and age above 50 year were associated
with increased mortality. In 12(9.2%) patients’ glomerulonephritis as a cause of AKI increased
the risk of dialysis requirement beyond 4 weeks.
Conclusion
In this setting the majority of patients with dialysis requiring AKI are young. We have observed
a shift in the etiology of dialysis requiring AKI in the last two decades; from Malaria and septic
abortion predominated to sepsis and glomerulonephritis.
Description
Keywords
Acute kidney injury, dialysis requiring AKI, AKI-D, Ethiopia