Outcomes of Patients with Acute Kidney Injury at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Incidence of acute kidney injury (AKI) based on data from high income countries is about 1 in 5 admissions; 1 in 4 of those that develop AKI die from its complications. Developing countries assume same incidence and outcome of AKI as developed countries. Objective: To describe the clinical presentation and determine the 90 day outcomes of patients with AKI at Moi Teaching and Referral Hospital (MTRH). Design: Prospective cohort study. Setting: MTRH General Wards. Participants: 103 patients consecutively recruited from January to July 2018. Interventions: Data was collected using a structured questionnaire and the patients were followed up from admission to discharge. Main Outcomes: Dialysis need, duration of hospitalization, recovery and mortality. Results: Mean age of the patients was 46.7±18.3 years. Majority were males at 61(60%) and most were in stage 3 disease at 65(63%). Main comorbidities were hypertension at 31(36.9%) and human immunodeficiency virus at 28(33.3%). Need for dialysis was at 31(30%) and strongly related to the AKI stage (p<0.0001). Complete recovery was observed in 29(52.7%) of the patients while 8(14.5%) had partial recovery and 18(32.7%) progressed to end stage renal disease. Recovery status was not determined by AKI stage (p=0.306). We had a 35(34%) mortality, most deaths occurred in stage 3 disease but statistically not significant (p=0.149). AKI causes were multifactorial, the most common being pre-renal with vomiting at 50(48.5%) and sepsis at 31(30%). Conclusion: Most patients presenting at MTRH with AKI had severe disease associated with high mortality.