Factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda.

Abstract

Introduction: Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda.

Aim: To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda.

Method: A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016-2017. A developed clinical audit form was used to collect data from patients' files. Both descriptive and inferential statistics were used to analyze data.

Results: Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis.

Conclusion: The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria.