Prevalence of Acute Renal Failure in the Intensive Care Unit of the CHU la Référence Nationale in Ndjamena

Abstract

Introduction: Acute renal failure (ARF) is a frequent clinico-biological syndrome in the intensive care unit. The aim of our study was to determine the prevalence of ARF in the general intensive care unit. Patients and Method : This was a cross-sectional study conducted over a period of 08 months in the intensive care unit of the CHU la Référence Nationale (CHU-RN) in N’Djamena. All patients presenting with ARF on admission were included. The clinical, biological and morphological characteristics of IR were studied. Data were analyzed using SPSS version 18.0 (Statistique Package for Social Sciences 18.0). Results: We recorded 206 ICU admissions, including 52 cases of acute renal failure, giving a prevalence of 25.2%. AKI accounted for 92.3%. The mean age of patients was 47 ± 17.1 years [19 - 86 years]. The sex ratio was 1.5. Functional signs were dominated by oligoanuria (84.6%) and disturbed consciousness (78.8%). Mean creatinemia was 125.2 mg/L [28.6 - 588.3 mg/L], mean uremia 2.3 g/L [0.7 - 6.0 g/L]. Ultrasonography was normal in 23.1%, showed dilation of the excretory tract on a single kidney in 1.9%, and stigmata of chronicity in 5.8%. According to the KDIGO classification of AKI, we found stage 3 in 53.9%. ARF was organic in 67.8%. Infectious causes accounted for 44.2%. Multivisceral failure syndrome was associated with ARF in 69.2%. Management was based on rehydration (82.7%), antibiotic therapy (53.8%), transfusion (42.3%), extrarenal purification (9.6%) and obstruction removal (3.8%). The outcome was favorable in 15.4% of cases, with recovery of renal function, and unfavorable in 84.6%, with 76.9% of deaths. The leading causes of death were multivisceral failure syndrome and AKI (p = 0.036). ICU stay was 4.4 days. Conclusion: Our study highlights the high mortality of ARF due to the multiplicity of causes, and calls for urgent measures to reduce its prevalence.