Outcomes of acute kidney injury in a department of internal medicine in ABIDJAN (cote D'IVOIRE)

Abstract

Aim: To investigate the prognostic factors of acute kidney injury (AKI) in our daily practice.

Methods: We analyzed the cohort of patients hospitalized for AKI in the period from January 2010 to December 2015 in the Department of Internal Medicine, University Hospital of Treichville. Kaplan-Meier curves were built for survival analysis. Cox regression analysis was used to identify independent predictors of mortality.

Results: We collected 414 cases of AKI during the study period. The mean age was 48.3 ± 16.8 years. We observed a male predominance with a sex ratio (236/178) of 1.32. In multivariate analysis, the predictive factors of death were age ≥ 65 years (HR = 2.13; 95% CI = 1.28-3.55; P = 0.004), AKI stage 3 (HR = 1.69; 95%CI = 1.13-2.50; P = 0.009), haemoglobin <8 g/dL (HR = 2.91; 95% CI = 1.79-4.72; P = 0.0001), infection (HR = 1.85; 95% CI = 1.21-2.83; P = 0.004) and drug-induced AKI (HR = 3.23; 95% CI = 1.65-6.29; P = 0.001). Factors associated with incomplete recovery or non-recovery of renal function beyond 3 months were age ≥ 65 years (OR = 4.76; 95% CI = 1.85-12.50;P = 0.001), hypertension (OR = 2.17; 95% CI = 1.07-4.34; P = 0.03), haemoglobin <8 g/dL (OR = 6.66; 95% CI = 2.94-8.28; P < 0.001), AKI stage 3 (OR = 9.09; 95% CI = 4.54-16.66; P < 0.001) malignant hypertension (OR = 5; 95% CI = 1.67-7.27; P = 0.005) and cancer (OR = 4.69; 95% CI = 2.22-6.63; P = 0.001).

Conclusion: The aetiologies are dominated by infections. The fatality rate is high and its risk factors are advanced age, low haemoglobin level, severe AKI, infection and drug intake. Prevention is essential.

Keywords: acute renal failure; anaemia; end-stage kidney disease; epidemiology.