IN HOSPITAL OUTCOME OF PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE IN THE ICU: AN AUDIT OF THE REGIONAL HOSPITAL BAMENDA

 

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https://storage.unitedwebnetwork.com/files/1099/bcc01ee8392c2d8e51a8bbfe23a6f0f7.pdf
IN HOSPITAL OUTCOME OF PATIENTS WITH ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE IN THE ICU: AN AUDIT OF THE REGIONAL HOSPITAL BAMENDA

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Arrah
Takow
Arrah Takow arrahestwil@gmail.com Faculty of Health Sciences, University of Bamenda Doctor of Medicine Bamenda Cameroon *
Alex Mambap tatangalex1984@gmail.com Faculty of Health Sciences, University of Bamenda Clinical Sciences Bamenda Cameroon -
Judethaddeus Ndifor thaddeusjude27@gmail.com Faculty of Health Sciences, University of Bamenda Clinical Sciences Bamenda Cameroon -
Steve Djontu stevedjontu@gmail.com Faculty of Health Sciences, University of Bamenda Clinical Sciences Bamenda Cameroon -
Ashuntantang-Some Gloria Gloria.ash60@gmail.com Faculty of Health Sciences, University of Bamenda Clinical Sciences Bamenda Cameroon -
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Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) are vital global health issues, whereby, in some cases, kidney replacement therapy (KRT) is needed with haemodialysis being the most common. Both AKI and CKD are complex syndromes with life threatening complications sometimes requiring intensive care services. The in-Intensive care unit (ICU) mortality rate of patients with AKI and CKD in developing countries is rising with patient outcome worse compared to high income countries. In developed countries, there is a high incidence and high mortality of AKI and CKD in the ICU; however this population is mainly elderly with high rates of comorbidities. In sub-Saharan Africa, patients are younger, have fewer comorbidities, which are mainly infectious diseases. In Cameroon, few studies have looked into kidney dysfunction in the ICU and have mainly been in urban settings; Yaounde and Douala. In Bamenda however, with a semi-urban population,we therefore aimed to study the in hospital outcome of patients with AKI and CKD in the ICU of the Regional Hospital Bamenda, North West Region, Cameroon.

This study was a prospective cohort design of 5 months duration including consenting patients admitted to the ICU at Regional Hospital Bamenda for at least 48 hours. Clinical data was extracted from patient files.Data was complimented with paraclinical examinations; full blood count, serum electrolytes and serum urea on admission. Serum creatinine was measured on admission, 48hours later and on discharge for those who survived. Each patient was followed up till transfer from the ICU, discharge or death. We noted need and access to haemodialysis, and noted kidney recovery on discharge for those with AKI, and mortality. Data was entered into CS Pro 8.0 and analyzed using R programming. P values <0.05 were considered statistically significant. Ethical clearance was issued by Institutional review board of the University of Bamenda, Identification number 2025/0031H/UBa/IRB.

Out of 142 participants retained, 87 (61.3%) participants had kidney dysfunction; 66 (75.9%) with AKI and 21 (24.1%) with CKD, 20(5 with AKI and 15 with Kidney Failure) required dialysis and 19(95%) accessed it (one with AKI lacked access due to financial constraint), 36(41.4%) of the 87 participants with kidney dysfunction died, 26 (70.2%) of the 37 participants with AKI alive on discharge had complete kidney recovery. Male sex (aHR=5.78, 95% CI =1.53, 21.8, p=0.010), being unemployed (aHR=3.80, 95% CI =1.09, 13.3, p=0.037), and severe AKI (aHR=8.67, 95% CI =1.95, 38.6, p=0.005) were independent risk factors for mortality.  

AKI and CKD are prevalent in the ICU, with requirements for dialysis in some. Mortality is high; however kidney recovery is good in survivors. Male sex, being unemployed, and severe AKI were risk factors for mortality.

Kewords