Prevalence of abnormal kidney function and 90-days outcomes among patients admitted on medical wards of Masaka Regional Referral Hospital in Uganda: a prospective study

Abstract

Background: Kidney disease burden is raising worldwide, raising a need to closely monitor high risk populations for swift response. However, there is limited data on the prevalence of abnormal kidney function and outcomes among patients admitted at regional referral health facilities in Uganda which are the first points of care for most patients in the country. We determined the prevalence of abnormal kidney function and 90-days outcomes among patients admitted on medical ward of Masaka Regional Referral Hospital. Methods: This was a prospective study conducted among adult patients admitted on medical wards between September 2020 to March 2021. Patients were enrolled if they met the following inclusion criteria: a) ≥18 years of age, 2) provided written informed consent, 3) had phone contacts to help with patient follow up. Spot urine sample was collected to assess for proteinuria and a blood sample was collected to assess serum creatinine levels. Abnormal kidney function was defined as decreased estimated glomerular filtration rate < 90 ml/minute /1.73m² or proteinuria of ≥1+ on spot urine dipstick. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epi formula. Patients with abnormal kidney function were followed up at 90 days post enrollment to determine their outcomes.Results: Were enrolled 357 patients. The overall prevalence of abnormal kidney function was 32.8% (117/357), 08 (2.2%) patients having proteinuria alone, 68 (19.1%) having decreased eGFR alone, and 41 (11.5%) having both proteinuria and decreased eGFR. The median age of 117 patients with abnormal kidney function was 52 (IQR 39-70) years and majority were males (54.7%). Of the 117 patients with abnormal kidney function, 108 were followed up to 90-days. The 90 days mortality was 69.4% (75/108), and 13.0% (14/108) had progressed to chronic kidney disease. Conclusions: The prevalence of abnormal kidney function was high and the many had adverse outcomes including death and progression to chronic kidney disease. To reduce on these adverse outcomes, patients at risk or with abnormal kidney function may benefit from basic screening and use of management protocols for kidney disease.