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Journal Article > Research

Impact of non-dialysis-requiring acute kidney injury on survival outcomes in non-critically ill hospitalized medical patients in a resource-limited setting: A retrospective cohort study

Tigist Workneh Leulseged, Nahom Dessalegn Mekonnen, Yared Adane Minas, Zekarias Tadele Alemneh, Yonas Hailu Gebeyeh, Thomas Tadesse Meshesha, Mebratu Abera Gurara, Betelhem Tiruneh Gebremedhin, Nathnael Tesfa Lisanu, Bezawit Woldaregay Wagaye , Mowlid Bedel Ahmed
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Abstract

INTRODUCTION

The severe consequences of acute kidney injury (AKI) have been well-documented in high-risk patient populations. However, the effects of milder forms in non-critically ill patients remain understudied, particularly in resource-limited settings. While the risk of mortality associated with these cases is considered low, it can still lead to various complications including prolonged hospitalization, which may influence long-term renal and patient survival. Hence, the objective of this study was to study the impact of non-dialysis-requiring AKI (NDR-AKI) on survival outcomes of non-critically ill medical patients admitted to St. Paul’s Hospital Millennium Medical College in Ethiopia during the period from July 2019 to January 2022.


METHODS

A retrospective cohort study was conducted among 300 non-critically ill medical patients, 93 with NDR-AKI and 207 without AKI. Descriptive statistics, including frequency distributions and median survival times, were employed to summarize the data. Kaplan-Meier curves and the log-rank test were utilized to compare survival experiences of groups. A Cox proportional hazards survival model was fitted to estimate the impact of NDR-AKI on time to recovery. Adjusted hazard ratio (AHR) with 95% confidence interval (CI) was used to report findings.


RESULTS

Two hundred four (68.0%) were discharged after improvement and the median recovery time was 16 days (95%CI: 13.5-18.5 days). Having NDR-AKI was associated with a 43% lower rate of achieving recovery (AHR=0.57, 95%CI=0.38, 0.84, p-value=0.004). Females were found to have a 1.41 times higher rate of recovery (AHR=1.41, 95%CI=1.03,1.94, p-value=0.033). Additionally, having tuberculosis (AHR=0.41, 95%CI=0.23,0.72, p-value=0.002) and being on anticoagulant (AHR=0.67, 95%CI=0.47,0.95, p-value=0.027) were associated with a 59% and 33% lower rate of recovery, respectively.


CONCLUSION

NDR-AKI significantly delays recovery compared to patients without AKI suggesting that even milder forms of AKI in non-critically ill patients can negatively impact patient outcomes. Early identification, prompt management, and addressing underlying causes are key to improving recovery and reducing long-term morbidity and mortality. Strict screening and monitoring of high-risk groups such as men, patients with tuberculosis, and those on anticoagulants is also crucial.


Countries
Ethiopia
Subject Area
non-communicable diseasekidney disease
DOI
10.7759/cureus.69358
Published Date
13-Sep-2024
Languages
English
Journal
Curēus
Volume / Issue / Pages
Volume 16, Issue 9, Pages e69358
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