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

Abstract

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.