Factors associated with acute kidney injury recovery in a tertiary hospital in Ghana: a prospective study

Abstract

IntroductionAcute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors.MethodsAn observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI.ResultsMean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively.ConclusionThe study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery.

Renal recovery and Its Predictors Among Hospitalized Patients with Acute Kidney Injury: A Prospective Study

“…Interestingly, the severity of AKI was signi cantly associated with an increased likelihood of non-renal recovery. This is consistent with previous studies that demonstrated a signi cant association between the severity of AKI and incomplete recovery (19,29,30,34). Furthermore, declined renal function at hospital discharge and severity of AKI are found to be associated with the progression of AKI to CKD and mortality.…”

Recovery of Renal Function in Clinical Patients with Acute Kidney Injury: Impact on Mortality

“…Acute Kidney Injury (AKI) is one of the most worrying complications in hospitalized patients, even in non-critical care units [ 1 ], due to its potential predisposition to unfavorable outcomes, such as chronicity of renal damage, lack of recovery, and mortality [ 2 ].…”

“…There is some evidence of renal recovery and mortality in intensive care units [ 2 , 12 ], but in non-critical care, there are few studies that address this relationship; consequently, it is believed that a better understanding of this condition would allow for more consistent care and, therefore, for the optimization of effective, preventive and individualized strategies as a way to mitigate risk and improve the clinical outcomes of hospitalized patients with AKI.…”