Acute Kidney Injury in Sub-Sahara Africa: A Single-Center Experience from Khartoum, Sudan

Yousif, Dalia; Topping, Alice; Osman, Maha F; Raimann, Jochen G.; Osman, Elfadil M; Kotanko, Peter; Abboud, Omar

doi:10.1159/000485214

Cited by 9 publications

(9 citation statements)

References 24 publications

(26 reference statements)

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“…In addition, the probable high rate of medical malpractice, antimicrobial resistance, increased incidence of water-borne diseases and many people living in unsanitary conditions may play a role. A single-center study done in Sudan also highlighted similar risk factors for acute kidney injury [ 21 ]. Globally, acute kidney injury is known to affect about 13 million persons, with 85% of those affected residing in developing countries [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The burden of renal admissions in a tertiary Hospital in Sierra Leone

et al. 2022

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Background The burden of both acute kidney injury and chronic kidney disease is on the rise globally. In sierra Leone, there has been no data on renal patients or admissions. This study intends to close this gap in knowledge and give preliminary data on the burden of renal disease in this country. Methods The study was a retrospective review of the case notes of patients admitted at Connaught Hospital, Freetown over a 2 year period. Data extraction was done using a well- structured proforma. Results A 2.7% renal admission burden was obtained; mean duration of hospital stay was 15.1 ± 14.7; mean age of patients was 47.2 ± 17.5 with a female preponderance. The common risk factors for chronic kidney disease were systemic hypertension (43%) and diabetes mellitus (24%). The common risk factors for acute kidney injury were sepsis (77%) and hypovolemia (15%). The in- hospital mortality rate was 47% and 73% were non-compliant with haemodialysis probably due to financial reasons. Conclusion There is a significant burden of kidney disease in our environment, affecting mainly our young and middle-aged population. A rational approach is to embark on kidney disease prevention programs.

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Section: Discussionmentioning

confidence: 99%

The burden of renal admissions in a tertiary Hospital in Sierra Leone

et al. 2022

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“…Most of the published data estimating the incidence of AKI were from high-income countries and included patients admitted to critical care units; settings where the ability to trace and detect suspected cases remains high. In a systematic review, the world incidence of AKI among hospitalized adults was estimated to be 21.6%, and the condition was found to be associated with a 23.9% increase in mortality (18)…”

Section: Discussionmentioning

confidence: 99%

Clinical Pattern and Outcome of Patients with Acute Kidney Injury in the Emergency Department of Saint Paul’s Hospital Millennium Medical College

Assefa,

Gebremedhin,

Bahta

et al. 2024

Preprint

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Background: Worldwide, 13.3 million people experience Acute Kidney Injury (AKI) each year. 85% of individuals impacted are thought to reside in underdeveloped nations. AKI continues to be one of the most widespread diseases in the world, although little is known about its clinical profile or outcome. The ability to pinpoint particular causes enables the implementation of targeted therapy and the development of preventative measures. The main goal of this study was to identify the patterns and outcomes of patients with AKI in the emergency department of Saint Paul's Hospital Millennium Medical College (SPHMMC). Method and materials: A cross-sectional study was conducted at the emergency department of SPHMMC in Addis Ababa, Ethiopia, from June 1-2021 to June 1-2022. Google Forms was used to collect the data, which was then cleaned up in Microsoft Excel before being sent to SPSS version 25 for analysis. To evaluate demographic, clinical profile, and outcome determinants, descriptive statistics, and binary logistic regression analysis were utilized. A paired samples T-test was used to compare the patient's laboratory findings at admission and discharge. Results: Among the 222 AKI patients included in the study 110 (49.5%) were males and 112 (50.5%) were females. The mean age of presentation was 48+18 years old. The majority of patients were from Addis Ababa (41.4%) and the Oromia region (40.5%). The most common causes of AKI were infections (26.2%), acute glomerulonephritis (20.4%), volume depletion (18.5%), and obstructive uropathy (16.6%). Uremic encephalopathy, infection, malignancy, potassium at discharge from emergency, and low initial Glasgow coma scale (GCS) significantly contributed to the death. The presence of nephrotoxic antibiotics, infection, and hyponatremia significantly contributed to the admission rate to the wards and intensive care unit (ICU). Conclusion: In conclusion, infection is the dominant cause and mortality predictor of AKI at SPHMMC. The majority of patients with infections were sepsis (78.1%), pyelonephritis (11.4%), and pneumonia (10.3%). Early initiation of antibiotics in the emergency is better for a good outcome.

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“…Glomerulonephritis which is an important cause of AKI was reported with small contribution of only 2%, this shows native kidney diseases may also contribute to AKI and should not be underestimated. Yousif et al reported glomerulonephritis as the predominant cause among patients who received haemodialysis for AKI in Sudan [18].…”

Section: Discussionmentioning

confidence: 99%

“…[3] The aetiology of AKI in LMIC was predominantly community acquired in contrast to developed world, however with improved critical care facilities there is trend towards hospital acquired AKI in developing countries. [4,5,6] In 2015 International Society of Nephrology (ISN) declared AKI to be a human right problem and called for reduction of deaths attributable to AKI by 2025 through an initiative dubbed 0 by 25 initiative [7]. Despite the scarcity of information on the burden of AKI in sub-Saharan Africa which hamper efforts in reducing its impact on morbidity and mortality, it is reported to be common with devastating outcome.…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury in ICU: Prevalence andOutcome at Muhimbili National Hospital, Dar es Salaam, Tanzania

2022

J Urol Ren Dis

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Background: Acute Kidney Injury (AKI) is common among hospitalized patients worldwide and has a poor prognosis among Intensive Care Unit (ICU) patients with mortality rates ranging from 10-90%. There is a paucity of data on the burden and spectrum of AKI in lower income countries especially those in sub-Saharan Africa region. This study was conducted at Muhimbili National Hospital (MNH) to determine the prevalence and outcome of AKI among patients admitted in ICU. Methodology:This was a retrospective descriptive study of all patients admitted to the MNH-ICU from January 2009 through December 2012. Medical records of the patients admitted to the ICU during the study period were reviewed and those with AKI were identified. Standardized pre-tested data instrument tools were used to collect socio-demographic data, clinical and laboratory parameters which included; date of admission to the ICU, type of patient (surgical or medical patient), duration of ICU stay, modality of ICU treatment for AKI, need for mechanical ventilation, or inotropic support and outcome.Results: A total of seven hundred and sixty-eight (768) patients were admitted to the MNH-ICU during the study period 2009-2012. Two hundred and thirty-three (233) case notes of patients met inclusion criteria for recruitment, were reviewed and included in the final analysis. Out of 233 participants, males were 60.9% and mean age of participants was 45.7 ± 17.8 years. The prevalence of AKI in this study was 57.9% (135/233) with the different AKIN stages contributing: I-(19.2%), II-(28.1%) and III-(52.6%). %). The length of stay in the ICU for those with AKI was 2 days (IQR 2-6) while that for those with no AKI was 3 days (IQR 2-8), P=0.094. Mortality among patients with AKI was higher than in those without AKI, 94.1% (127/135) compared to 91.8% (90/98), p=0.0037. For patients with AKI, 67.4% were recorded as having sepsis while 15.5% had septic shock. Factors associated with mortality included underlying CKD (p=0.011), the need for mechanical ventilation (p=0.046), and the need for vasopressor in ICU (p=0.018). Conclusion:The prevalence of AKI was high (57.9%) with high mortality of 94.1% Mortality. Factors associated with mortality included underlying CKD, the need for mechanical ventilation and vasopressors.

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Acute Kidney Injury in Sub-Sahara Africa: A Single-Center Experience from Khartoum, Sudan

Cited by 9 publications

References 24 publications

The burden of renal admissions in a tertiary Hospital in Sierra Leone

The burden of renal admissions in a tertiary Hospital in Sierra Leone

Clinical Pattern and Outcome of Patients with Acute Kidney Injury in the Emergency Department of Saint Paul’s Hospital Millennium Medical College

Acute Kidney Injury in ICU: Prevalence andOutcome at Muhimbili National Hospital, Dar es Salaam, Tanzania

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