OUTCOME OF HEMODIALYSIS IN ACUTE KIDNEY INJURY PATIENTS AND FACTORS ASSOCIATED WITH SURVIVAL AMONG PATIENTS IN SPHMMC, ADDIS ABABA, ETHIOPIA.

Abstract

Abstract Background Hemodialysis usually has a positive outcome in patients with Acute Kidney Injury. It has improved signs and symptoms of AKI. Hemodialysis is associated with marked benefits. These include improved solute clearance, better blood pressure control, and reduced medication requirement It has improved the quality of life of patients significantly. However it has some complications associated with it which include hypotension, cramps, nausea and vomiting, Headache, chest pain, back pain etc. Studies have shown that there are factors which affect the outcome of hemodialysis. These factors could be patient factors or technical. Saint Paul’s Hospital Millennium Medical College (SPHMMC) is one of the pioneers in having sustainable dialysis unit which is government funded in Ethiopia. This study was conducted to describe the clinical profile and outcome of adult Acute Kidney Injury patients treated with intermittent hemodialysis at the dialysis center of SPHMMC. Objectives: The purpose of this study is to identify the negative outcomes of dialysis and factors associated with survival among in AKI patients in SPHMMC Method- A Retrospective record review was conducted, in order to determine the Outcome of dialysis in AKI patients in medical ward at \SPHMMC who were admitted from February 1 2015 to December 31 2015.and the charts were collected after checking the HMIS chart from the dialysis unit. A total of 160 cards were recorded in the year but only 117 charts were found. The data were analyzed by summarizing, tabulating and presenting in various formats by using SPSS version 21.then bivariate and multivariate analysis was done to determine the variables who have association with the outcome. Significance was determined if p value was <0.05 Result- Out of total 117 patients who has undergone hemodialysis 83(70.3%) of them had improvement.34 (28.8%) of them died. Of those 83 patients who had improvement 49 of them were females and the rest 34 were males. The mean age of the patients who has undergone hemodialysis during the one year period was 37.3 years. Most of the patients were from Oromia region followed by Addis Ababa and SNNP Regions. Patients who had AKI due to sepsis and has undergone hemodialysis has increased, it is 25.4%. Sepsis has been associated with 3.5 times increased risk of death in the patients. 26.3% of patients has other cause of AKI. Those patients are associated with 0.25 times increased risk of death. Death was associated in 24.6% of patients. Conclusion-While sepsis is the single most important factor associated with the negative outcome of hemodialysis. Patients who developed AKI due to Sepsis has increased risk of mortality than other patients who had AKI due to other causes Recommendation- Aggressive measures should be taken in treating Sepsis since it is associated with increased mortality in AKI patients who undergo hemodialysis