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

Abstract

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.