Clinical pattern and outcome of acute kidney injury patients from a Tertiary Health Institution in Northwestern Nigeria

Abstract

Background: Acute kidney injury (AKI) is a common cause of hospitalization associated with high mortality, especially in developing countries. Despite better understanding of the pathophysiology, mortality from AKI remains source of concern worldwide. AKI varies between countries and even within the same environment due to diverse diagnostic criteria. Studies from developing nations have alluded to the high incidence of AKI from preventable and potentially reversible causes affecting predominantly children and young adults. The growing concern as to whether the pattern and outcome have changed in recent times prompted this study. Materials and Methods: All the patients that met RIFLE criteria for the diagnosis of AKI were audited with specific reference to clinical pattern and outcome in Northwestern Nigeria. Results: A total of 318 patients (198 males and 120 females) that met RIFLE criteria for AKI were seen with age range and mean of 20–80 years and 42.0 ± 12.0 years, respectively. Severe gastroenteritis, septicemia, obstetric complications, and toxic nephropathies were leading causes of AKI. Main clinical features in order of magnitude were oliguria, fever, body swelling, unusual weakness, and vomiting. Sixty-eight percent had hemodialysis while 32% were managed conservatively. Overall, mortality was 26.4%, and conservative management was associated with higher mortality than those that had hemodialysis. Factors associated with high mortality were late presentation, severe anemia, and sepsis. Conclusion: AKI is common in our setting and causes are largely preventable and treatable. Identification and prompt correction of reversible causes and timely referral of severe cases to nephrologists are of immense importance.

Keywords

• Acute kidney injury
• causes
• pattern
• treatment and outcome