Patterns of Acute Kidney Injury in a Medical Emergency Department in Sub-Saharan Africa

Abstract

Background: Acute kidney injury (AKI) is a common in community and a serious outcome in hospital setting. Despite the progress of dialytic and non-dialytic therapeutic means, its mortality remains high. Our objective was to contribute to a better knowledge of how AKI managed in an emergency medical ward in an African country located in the southern part of the Sahara. Patients and Methods: We conducted a retrospective study from January 1 to December 31, 2019, conducted at the emergency department of the University Teaching Hospital of Bouake, on cases of AKI. Results: During the study period, we collected 221 cases of AKI out of a total of 1778 files giving a prevalence of 12.4%. The mean age was 54 ± 19 years. A male predominance with a sex ratio of 1.4 was observed. The main past histories were hypertension in 40.4%, cardiac disease in 16.9%, and diabetes in 14.3%. The patients in were classified in 63.8% of cases as stage I, in 22.1% as stage II and in 14.1% as stage III according to the AKIN criteria. AKI was functional in 93.2% of cases. Hemodialysis was indicated in 15 (6.8%) patients, but only 3 (1.4%) underwent it. The mortality rate was 45.2%. Factors associated with mortality were: creatinine level greater than or equal to 30 mg/l, sepsis and impaired vigilance. Conclusion: Acute renal failure was frequent in subjects under 60 years old. Its mechanism of occurrence is functional and therefore it can be prevented by vascular filling. The majority of patients were seen at AKIN Stage I. The outcome was favorable in more than one third of the cases and the mortality rate remains high.