Demographic Analysis of Renal Failure Patients Presenting to the Emergency Unit

Kazancıoğlu, Rümeyza; Kutlu, Cigdem; Caymaz, Muazzez; Tatlı, Emel; Sar, Fuat

doi:10.1016/s1561-5413(08)60005-8

Cited by 1 publication

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study found that, overall 30-day mortality of patients who needed dialysis was somewhat higher (39%) than in developed countries which had a mortality of around 8.8% [17]. Higher mortality found in our study can be attributed to late presentation to the hospital and lack of dialysis in more than 50% of patients who meet the indications.…”

Section: Discussionmentioning

confidence: 40%

“…The median age was 49 years, which is higher than the average ED population, which has a median age of 30 years [16]. However this is lower than patients presenting to EDs in HIC’s [17, 18]. This could be attributed to the presence of untreated comorbidities such as hypertension, unique etiologies of renal failure in sub-Saharan Africa, and less access to preventive care.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Profile and outcome of patients with emergency complications of renal failure presenting to an urban emergency department of a tertiary hospital in Tanzania

et al. 2019

View full text Add to dashboard Cite

BackgroundRenal failure carries high mortality even in high-resource countries. Little attention has been paid to renal failure patients presenting acutely in emergency care settings in low-to-middle income countries (LMIC). Our aim was to describe the profile, management strategies and outcome of renal failure patients presenting with indications for emergent dialysis to an urban Emergency Department (ED) in a tertiary public hospital in Tanzania.MethodsThis was a prospective cohort study of consecutive patients (age ≥ 15 yrs) presenting to the Emergency Medicine Department of Muhimbili National Hospital from September 2017 to February 2018. All patients with renal failure and complications requiring acute dialysis were included. A structured data collection sheet was used to gather demographics, clinical presentation, management strategies and outcomes. Data were summarized with descriptive statistics. Logistic regressions were performed to determine factors associated with receiving dialysis and with mortality.ResultsWe enrolled 146 patients, median age was 49 years (IQR 32–66 years), and 110 (75.3%) were male. Shortness of breath 67 (45.9%) and reduced urine output 58 (39.7%) were the most common presenting complaints. The most common complications were hyperkalemia 77 (53%), uremic encephalopathy 66 (45%) and pulmonary edema 54 (37%). All patients were hospitalized, and 61 (42%) received dialysis. Overall mortality was 39% (57 patients); the mortality in non-dialysed patients was 53% vs. 20% (p < 0.0005) in those receiving dialysis. 54% of patients with health insurance were dialyzed, compared to 39% who paid out of pocket (adjusted OR = 0.3, 95%CI: 0.1–0.9). Patients (≥55 years) were less likely to be dialysed (adjusted OR = 0.2 [0.1–0.9]). Independent predictors of mortality were vomiting (OR = 6.2, 95%CI: 1.8–22.2), oliguria (OR = 3.4, 95%CI: 1.2–9.5), pulmonary edema (OR = 4.6, 95%CI: 1.6–14.3), creatinine level > 1200umol/L (OR = 5.0 95%CI: 1.4–18.2), and not receiving dialysis (OR = 8.0, CI: 2.7–23.5). Female sex had a lower risk of dying (OR = 0.13, CI: 0.03–0.5).ConclusionsIn this ED in LIC, acute complications of renal failure created a need for ED stabilization and emergent dialysis. Overall in-hospital mortality was high; significantly higher in undialysed patients. Future studies in LICs should focus on identification of categories of patients that will do well with conservative therapy.

show abstract

Section: Discussionmentioning

confidence: 40%