Acute Kidney Injury and Its Associated Factors Among Patients Admitted to Adult Intensive Care Unit in Public Hospitals of Addis Ababa, Ethiopia,2024

Abstract

Abstract Background: Acute kidney injury is a clinical syndrome characterized by a sudden decrease in or loss of kidney function. Despite the higher rates of acute kidney injury along with mortality in intensive care units, the magnitude and associated factors of acute kidney injury among adult ICU admitted patients were not thoroughly investigated in the study area. This study aims to ascertain the magnitude and associated factors of AKI in the adult ICU of a public hospital in Addis Ababa, Ethiopia. Method: A multicentre cross-sectional study was conducted among adult intensive care unit admitted patients in public hospitals of Addis Ababa, Ethiopia, from 1st January 2022 to 31st December 2023.Using simple random sampling four Hospitals was selected among the twelve public hospital provides ICU services in the city. 266 study participants were included in the study and data was collected retrospectively from the patient charts. After completing data collection by Kobo Toolbox Collect software, it was exported in excel format, and then the data was imported to SPSS version 27 for further processing and analysis. In the bivariate analysis, Variables with a p-value of less than 0.25 were included to multivariate analysis to identify any possible association among them. The strength of association was assessed by calculating an adjusted odd ratio (AOR) along with a 95% confidence interval (CI). Finally, a p-value of less than 0.05 was used to determine statistical significance. Results: Among the 266 study participants, 27.1% of adult ICU-admitted patients in public hospitals of Addis Ababa experienced acute kidney injury, with a 95% CI of ([21.8 - 32.8]). Patients with diabetes mellitus (AOR = 3.08; 95% CI: [1.52-6.25]), Contrast usage (AOR = 5.1; 95% CI: [2.34-11.15]), hypertension (AOR = 6.02; 95% CI: [1.9-19.14]), vasopressor usage (AOR = 14.99; 95% CI: 4.32-52), WBC >12x109 (AOR=2.46;95%CI:[1.27-4.77])and increased length of ICU stay (AOR = 2.01; 95% CI: [1.04-3.9]) were identified as independent factors of acute kidney injury. Conclusion: This study has assessed magnitude and associated factors of AKI among patients admitted to adult intensive care unit in public hospitals of Addis Ababa, Ethiopia. Accordingly, the magnitude of Acute Kidney Injury among Adult Intensive Care Unit admitted patients was 27.1%. It was found that patients with Hypertension, Contrast Usage, Diabetes Mellitus, vasopressor usage, increased WBC count and increased length of ICU stay were significantly associated with the acute kidney injury. Keywords: Acute kidney injury (AKI), Adult intensive care unit, Associated factors of Acute kidney injury.