IN-HOSPITAL OUTCOMES AND MORTALITY PREDICTORS IN CHRONIC KIDNEY DISEASE PATIENTS IN RESOURCE-LIMITED SETTINGS: A CASE STUDY FROM A TERTIARY HOSPITAL IN TANZANIA

 

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https://storage.unitedwebnetwork.com/files/1099/3033ed5b5ebf1f26715225344f2b2a73.pdf
IN-HOSPITAL OUTCOMES AND MORTALITY PREDICTORS IN CHRONIC KIDNEY DISEASE PATIENTS IN RESOURCE-LIMITED SETTINGS: A CASE STUDY FROM A TERTIARY HOSPITAL IN TANZANIA

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Jonathan
Mngumi
Jonathan Mngumi jonawilly01@gmail.com Muhimbili National Hospital Internal Medicine Dar es Salaam Tanzania *
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Chronic kidney disease (CKD) is a growing global health burden, particularly in sub-Saharan Africa (SSA) where younger populations are disproportionately affected and access to kidney replacement therapy (KRT) remains limited. In Tanzania, many patients present with advanced disease and face financial barriers to care. We conducted a hospital-based prospective cohort study at Muhimbili National Hospital (MNH), to assess in-hospital outcomes and predictors of mortality among CKD patients between September 1, 2024, and January 31, 2025.

Data were collected using structured interviews and review of medical records. Statistical analysis involved descriptive statistics, and Cox regression to identify predictors of mortality. Ethical approval was obtained from the Muhimbili University of Health and Allied Sciences Research and Publication Committee, and informed consent was secured from all participants.

A total of 207 participants were included, with a mean age of 55.5 ± 14.6 years; the majority were male (56.0%). In-hospital mortality was 17.4%. Severe hyperkalemia (55.6%) was the most frequently reported immediate cause of death. In multivariate Cox regression analysis, admission to the high dependency unit (aHR: 1.42; 95% CI: 1.02–1.98), presence of infection at admission (aHR: 1.54; 95% CI: 1.07–2.23), and conservative management without dialysis (aHR: 1.68; 95% CI: 1.15–2.46) were independently associated with increased risk of in-hospital mortality.

In-hospital mortality among CKD patients was high and driven by modifiable factors; early infection control, timely access to dialysis, and critical care support are essential to improve outcomes.

Kewords