Kidney Failure in the Emergency Department of the Teaching Hospital of Treichville: Incidence and Associated Factors with Mortality

Abstract

Context: Kidney disease is now recognized as a major public health issue with an increasing trend worldwide. Objectives: To determine the incidence and describe the profile of patients admitted for kidney injury in the emergency department. Materials and Methods: This was a prospective and analytical study conducted over six (6) months from March 2021 to August 2021 at the medical emergency department of the Teaching Hospital of Treichville in Abidjan (Cote-d’Ivoire). Sampling was exhaustive, and data were collected using pre-established forms, entered into Epi Data software, and analyzed using STATA SE version 16 and SPSS version 25. Results: Out of 2043 patients admitted to the emergency department during the study period, 285 cases of kidney injury were observed, representing a prevalence of 13.9%. Furthermore, 218 cases were newly discovered, corresponding to an incidence of 10.6%. The mean age was 48.69 ± 16.62 years, with a sex ratio of 1.69 and a male predominance, accounting for 62.8% of patients. Comorbidities included hypertension in 54.1% of cases, followed by diabetes in 24.3%. The most commonly observed clinical signs were anemia syndrome in 61% of patients and pulmonary condensation syndrome in 49.5% of cases. Kidney injury was severe in 52.98% of cases. It was undetermined in 44.5% of cases, chronic kidney disease (CKD) in 34.4%, and acute kidney injury in 21.1% of patients. Hemodialysis was initiated in 54 out of 151 patients who had an indication for it. In total, 51 patients (23.4%) died. In multivariate analysis, altered consciousness was the main risk factor associated with mortality [(p < 0.001; OR (95% CI) = 3.59 (1.84 - 7.04)]. Conclusion: Kidney failure is common in the medical emergency department of the Teaching Hospital of Treichville and is associated with high mortality.