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. 2024 Jun 26;19(6):e0304006.
doi: 10.1371/journal.pone.0304006. eCollection 2024.

Incidence and predictors of acute kidney injury among adults admitted to the medical intensive care unit of a Comprehensive Specialized Hospital in Central Ethiopia

Taye Mezgebu Ashine  1 , Migbar Sibhat Mekonnen  2 , Asnakech Zekiwos Heliso  1 , Yesuneh Dejene Wolde  3 , Getachew Ossabo Babore  1 , Zerihun Demisse Bushen  4 , Elias Ezo Ereta  1 , Sentayehu Admasu Saliya  1 , Bethelhem Birhanu Muluneh  4 , Samrawit Ali Jemal  3
Affiliations

Incidence and predictors of acute kidney injury among adults admitted to the medical intensive care unit of a Comprehensive Specialized Hospital in Central Ethiopia

Taye Mezgebu Ashine et al. PLoS One. .

Abstract

Background: Acute kidney injury is a prevalent complication in the Intensive Care Unit (ICU) and a significant global public health concern. It affects approximately 13 million individuals and contributes to nearly two million deaths worldwide. Acute kidney injury among Intensive Care Unit patients is closely associated with higher rates of morbidity and mortality. This study aims to assess the incidence of acute kidney injury and identify predictors among adult patients admitted to the medical Intensive Care Unit.

Method: A retrospective follow-up study was conducted by reviewing charts of 317 systematically selected patients admitted to the Intensive Care Unit from September 1, 2018, to August 30, 2022, in Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital. The extraction tool was used for the data collection, Epi-data version 4.6.0 for data entry, and STATA version 14 for data cleaning and analysis. The Kaplan-Meier, log-rank test, and life table were used to describe the data. The Cox proportional hazard regression model was used for analysis.

Results: Among the total study participants, 128 (40.4%) developed Acute Kidney Injury (AKI). The incidence rate of Acute Kidney Injury was 30.1 (95% CI: 25.33, 35.8) per 1000 person-days of observation, with a median survival time of 23 days. It was found that patients with invasive mechanical ventilation (AHR = 2.64; 95% CI: 1.46-4.78), negative fluid balance (AHR = 2.00; 95% CI: 1.30-3.03), hypertension (AHR = 1.6; 95% CI: 1.05-2.38), and a vasopressor (AHR = 1.72; 95% CI: 1.10-2.63) were independent predictors of acute kidney injury.

Conclusion: The incidence of Acute Kidney Injury was a major concern in the ICU of the study area. In the intensive care unit (ICU), it was found that patients with vasopressors, invasive mechanical ventilation, negative fluid balance, and chronic hypertension were independent predictors of developing AKI. It would be better if clinicians in the ICU provided targeted interventions through close monitoring and evaluation of those patients with invasive ventilation, chronic hypertension, negative fluid balance, and vasopressors.

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Conflict of interest statement

The authors declared no conflict of interest.

Figures

Fig 1
Fig 1. Socio-demographic characteristics of intensive care unit patients admitted to Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Hosanna, Ethiopia, 2023.
Fig 2
Fig 2. Overall Kaplan-Meier curve for critically ill ICU patients at Wachemo University Nigist Eleni Mohammad Memorial Comprehensive Specialized Hospital, Hosanna, Ethiopia, 2023(N = 317).
Horizontal axis (X): shows the time of analysis in (days). The vertical axis (Y): indicates survival probability—middle line (downward) survival function.
Fig 3
Fig 3. The Kaplan-Meier curve comparison among fluid balance category for ICU patients at Wachemo University Nigist Eleni Mohammad Memorial Comprehensive Specialized Hospital, Hosanna, Ethiopia, 2023(N = 317).
Fig 4
Fig 4. Displays the Cox-Snell residual test to assess the proportional assumption of each covariate and the overall Cox proportional hazard model.
See this image and copyright information in PMC

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