Clinical Profile and Short-Term Outcomes of Acute Kidney Injury in Patients Admitted to a Teaching Hospital in Ethiopia: A Prospective Study

• Published in: International journal of nephrology and renovascular disease 2021-01, Vol.14, p.201-209
• Main Authors: Abebe, Abinet, Kebede, Bezie, Wobie, Yohannes
• Format: Article
• Language: English
• Subjects: acute kidney injury; Congestive heart failure; Creatinine; Diabetes; ethiopia; Heart failure; Hospitalization; Hospitals; Hypertension; Kidney diseases; Laboratories; Length of stay; Mortality; Original Research; Patients; Quality of life; Renal replacement therapy; Sepsis; short-term outcomes; Sociodemographics; Statistical analysis; Variables
• ISSN: 1178-7058; 1178-7058
• DOI: 10.2147/IJNRD.S318037

Acute kidney injury (AKI) is a common complication in hospitalized patients and a marker for poor patient outcomes. It is associated with a high risk of mortality and other short- and long-term adverse outcomes. We aim to assess the clinical profile and short-term outcomes of acute kidney injury in adult patients admitted to the medical ward. A hospital-based prospective observational study was conducted from October 2019 to January 2020. All adult patients diagnosed as AKI using kidney disease improving global outcomes (KIDGO) criteria were included in the study and prospectively followed to document the short-term outcomes. Outcomes and their predictors were determined using multivariate logistic regression. P-value less than 0.05 was taken as statistically significant. A total of 160 patients were included in the study. Out of this, 96 (60%) were males, 118 (74%) had community-acquired AKI, and 51 (32%) had stage 3 AKI. Common causes of AKI were hypovolemia 62 (39%) and sepsis 35 (22%). Hypertension 69 (43%) and heart failure 50 (31%) were common underlying comorbidities. Fifty-six (35%) patients developed systemic complications, 98 (61.2%) had persistent AKI, 136 (85%) had prolonged length of hospital stay, and 18 (11%) were readmitted to the hospital. The presence of AKI-related complication (AOR=2.7, 95% CI: 1.14-6.58, p=0.024), and duration of AKI (AOR=9.7, 95% CI: 2.56-36.98, p=0.001) were factors associated with prolonged length of hospital stay. Preexisting CKD (AOR=3.6, 95% CI: 1.02-13.14, p=0.035) and stage 3 AKI (AOR=2.1, 95% CI: 1.6-3.57, p=0.04) were factors associated with 30-day hospital readmission. Hypovolemia and infections were the primary causes of AKI. Complications, prolonged length of hospital stay, persistent AKI, and rehospitalization were poor short-term outcomes of AKI. Early diagnosis and timely management of AKI particularly in high-risk hospitalized patients, and post-AKI care including management of comorbidities for AKI survivors should improve these poor short-term outcomes.