Incidence and Short-Term Outcome of Acute Kidney Injury in Critically Ill Patients in Southern Nigeria: A Multi-Centre Retrospective Study.

Abstract

Background and objectives: Despite the burden and severity of AKI in ICU patients, there is limited epidemiologic information in Sub-Saharan Africa. Epidemiologic data on AKI in critically ill patients are required to advocate for government health policies that will reduce the burden of AKI. This study determined the incidence, aetiologies, and short-term outcomes of AKI in ICU patients in Southern Nigeria.

Methods: A multi-centre retrospective descriptive study of all patients with medical conditions, who developed AKI in the ICU of the participating hospitals during the study period. Data collected include socio-demographics, hospital-related data such as duration of stay in ICU, past and current medical history, and outcome of illness.

Results: Out of 473 cases, AKI was diagnosed in 203 (42.9%). Seventy-three (36.0%) were oliguric, 50.2% had non-oliguric AKI, while it was not specified in 13.8% patients. The most common causes of AKI were hypovolaemia (34.0%) and sepsis (27.6%). Factors associated with the development of AKI were sepsis [AOR:6.17; CI:2.33-16.32; p = <0.001] and need for inotropes [AOR:2.03; CI:1.34-3.94; P = 0.003]. Although dialysis was indicated in 34 (16.7%) of the AKI patients, 58.8% of them received it. One hundred and sixteen (57.1%) of the AKI patients were discharged with full renal recovery, while 40.9% died.

Conclusion: Four out of every 10 patients admitted into the ICU developed AKI, and the common aetiologies were hypovolaemia and sepsis. Regular critical care training is required to effectively identify at-risk patients and to take prompt measures towards mitigating these risks.