PATTERNS OF ACUTE KIDNEY INJURY AMONG PATIENTS ADMITTED TO SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

ABSTRACT Background: Acute kidney injury (AKI) is a frequently occurring syndrome of heterogeneous etiology and various pathophysiological processes that lead to decreased kidney function. Risk factors for the prevalence and pattern of AKI include environmental, socioeconomic, cultural and patient factors. In HIC, AKI occurs more frequently in older hospitalized patients with multiple comorbidities. In LMIC, AKI risk factors are often modifiable, community-acquired, and affect younger individuals. The first step in management of AKI is to determine the patterns and possible causes. Objectives: To determine the patterns of AKI among patients admitted to medical ward at SPHMMC, Ethiopia. Methods: Retrospective cross-sectional study was conducted at SPHMMC, Addis Ababa, Ethiopia on 155 adult patients who were admitted to medical ward from 01 May 2022 to 30 April 2023 GC and selected by systematic random sampling method. Data was collected by reviewing medical records from patients’ card and electronic record. The data was filled in prepared checklists, analyzed using SPSS version 25 and Multinomial Logistic Regression Model was used Result: The study showed that the most common cause of AKI among medical ward admitted AKI patients is AGN which attributes for 56.8% of patients. ATN or AIN were the causes for 29% of patients whereas pre-renal AKI, post-renal AKI and other intrinsic-renal were the causes for the remaining 14.2%. Patients with age group 15 to 44 yrs, stage 1or stage 2 AKI patients, stage 3 non dialysis requiring AKI patients and patients who are neither pregnant nor in peripartal period have significantly lower probability of having ATN or AIN compared to that of AGN. Patients with stage 3 non dialysis requiring AKI, no underlying CKD, no underlying comorbidities and neither pregnant nor in peripartal period have significantly lower probability of having Pre-renal AKI or Post-renal AKI or others compared to that of AGN. Conclusions: Among medical ward admitted AKI patients, intrinsic-renal cause (AGN followed by ATN or AIN) is the most frequent pattern of AKI followed by pre-renal and post-renal causes. Age of the patient, Severity of AKI, AKI on CKD, comorbidity and pregnancy are significantly associated with patterns of AKI. Serologic tests and kidney biopsy might be much helpful to identify specific causes of AGN. Key words: AKI, pattern, risk factors, causes