Abstract
Aims: We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa. Methods: A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015. Results: The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired. Most patients with AKI are young with a weighted mean age of 41.3 standard deviation (SD) 9.3 years, and a male to female ratio of 1.2 : 1.0. Medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 – 27% of cases and surgical causes in 2 – 24% of cases. In the reported studies, between 17 and 94% of patients who needed dialysis received this. The mortality of AKI in adults in Africa ranged from 11.5 to 43.5%. Conclusions: Most reported cases of AKI in Africa originate in the community. The low incidence of hospital-acquired AKI is likely to be due to under ascertainment. Most patients with AKI in Africa are young and have a single precipitating cause. Prominent among these are infection, pregnancy complications and nephrotoxins. Early treatment can improve clinical outcomes.
Highlights
Recent studies show that minor acute changes in kidney function are associated with increased mortality [1, 2] and that acute kidney injury may be a harbinger of chronic kidney disease [3, 4]
We searched Pubmed for papers on acute kidney injury/acute renal failure in adults in Africa using a search filter [11] from 2000 to AKI in Africa
Causes of AKI in Africa In Africa, medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 – 27% of cases and surgical causes in 2 – 24% of cases [8, 12, 13, 18, 23, 25, 26]
Summary
Recent studies show that minor acute changes in kidney function are associated with increased mortality [1, 2] and that acute kidney injury may be a harbinger of chronic kidney disease [3, 4]. The majority of cases of AKI in high- and middle-income countries are hospital-acquired and most patients are elderly [5]. Rural health centers are not able to measure renal function Even where these tests are available, doctors may not think of the possibility of AKI and may not order kidney function tests, or the patients may not be able to afford these tests. The challenges of reducing the burden of AKI in low- and middle-income countries have been discussed [9]. These challenges are being addressed by the International Society of Nephrology in the AKI “0 by 25” initiative [10]. This initiative arises from the understanding that AKI is preventable and treatable and that many lives are being uselessly lost
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
