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. 2022 Feb 3;14(2):e21873.
doi: 10.7759/cureus.21873. eCollection 2022 Feb.

Clinical Profile of Adult Patients Presenting With Renal Dysfunction to a Tertiary Hospital Emergency Department

John Masina  1 , Muhammed Moolla  1 , Feroza Motara  1 , Ismail S Kalla  2 , Abdullah E Laher  1
Affiliations

Clinical Profile of Adult Patients Presenting With Renal Dysfunction to a Tertiary Hospital Emergency Department

John Masina et al. Cureus. .

Abstract

Background Renal dysfunction is a potentially life-threatening condition that is commonly encountered in the emergency department (ED). This study aimed to describe the clinical profile of patients presenting with renal dysfunction to a tertiary-level hospital ED. Methods Medical records of patients presenting to the ED with renal dysfunction over a six-month period (July-December 2017) were reviewed. A descriptive analysis of the data was performed. Results Serum creatinine levels were measured in 7,442 (69.9%) of the 10,642 patients that were triaged into the ED. Of these, 208 (2.8%) were identified with renal dysfunction, of which 192 consented to study participation. The median age of study subjects was 49.5 (IQR 38.8-63.0) years; 108 (56.3%) were male; proteinuria on urine dipsticks was demonstrated in 108 (56.3%); 72 (37.5%) were HIV-positive; 66 (39.6%) required dialysis; 11 (5.7%) were admitted to the ICU; and 59 (30.7%) died prior to hospital discharge. More patients presented with acute kidney injury (AKI) (46.9%) compared to chronic kidney disease (CKD) (27.6%) and acute on chronic kidney disease (AoCKD) (25.5%). Sepsis was the most common precipitant of AKI (42.2%) and AoCKD (30.6%), while chronic hypertension (35.8%) and diabetes mellitus (34.0%) were the most common comorbidities in subjects with CKD. Conclusion Patients presenting to the ED with various risk factors and comorbidities, including HIV, sepsis, hypertension, and diabetes mellitus, may have underlying renal dysfunction. ED clinicians should therefore adopt a low threshold to screen for renal dysfunction in these patients.

Keywords: acute kidney injury; chronic kidney disease; diabetes mellitus; emergency department; hiv; hypertension; renal dysfunction; sepsis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Findings of the 143 subjects in whom renal ultrasonography was performed
*Small and hyperechoic kidneys ^Large and hyperechoic kidneys in subjects with HIV
See this image and copyright information in PMC

References

    1. Care of the critically ill emergency department patient with acute kidney injury. Joslin J, Ostermann M. Emerg Med Int. 2012;2012:760623. - PMC - PubMed
    1. Impact on outcomes across KDIGO-2012 AKI criteria according to baseline renal function. Acosta-Ochoa I, Bustamante-Munguira J, Mendiluce-Herrero A, Bustamante-Bustamante J, Coca-Rojo A. J Clin Med. 2019;8 - PMC - PubMed
    1. Global epidemiology and outcomes of acute kidney injury. Hoste EA, Kellum JA, Selby NM, et al. Nat Rev Nephrol. 2018;14:607–625. - PubMed
    1. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. Hill NR, Fatoba ST, Oke JL, Hirst JA, O'Callaghan CA, Lasserson DS, Hobbs FD. PLoS One. 2016;11:0. - PMC - PubMed
    1. KDIGO Clinical Practice Guideline for acute kidney injury: notice. Kidney Int Suppl (2011) 2012;2:1.

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