Incidence and Predictors of Acute Kidney Injury among Patients Admitted to Adult Intensive Care Unit at West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A multicenter retrospective follow-up study

Abstract

Abstract Introduction: Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decrease in or loss of kidney function. In Ethiopia, the morbidity and mortality associated with acute kidney injury is an important challenge for the health community and patients. However, there is limited evidence on the incidence and predictors of acute kidney injury among intensive care unit patients in Ethiopia. Objective: To assess incidence and predictors of acute kidney injury among intensive care unit patients in West Amhara comprehensive specialized hospitals, Northwest Ethiopia, 2023. Methods: A multicenter institution-based retrospective follow-up study was conducted from January 1, 2020-December 31, 2022 among intensive care unit patients admitted to West Amhara comprehensive specialized Hospitals, Northwest Ethiopia. A total of 628 patient charts were chosen using systematic random sampling. Data were collected using a checklist, entered using Epi-data 4.6, and exported to STATA version 14 software for data analysis. After the bivariable and multivariable Cox regression analysis, an Adjusted Hazard Ratio (AHR) with 95% confidence intervals (CI) at p-value of <0.05 was reported to declare the strength of association and statistical significance, respectively. Result: The overall incidence rate of acute kidney injury was 19.67 per 1000 (95% CI: 15.76-24.56) person-day of observation with a median survival time of 17 days (IQR=11–35). Sepsis (AHR= 2.02: 95% CI: 1.06, 3.85), diabetes mellitus (AHR=2.46: 95% CI: 1.44, 4.22), congestive heart failure (AHR= 3.11: 95% CI: 1.57, 6.16), Anemia (AHR=3.28: 95% CI: 1.77, 6.09), Vasopressors (AHR=2.57: 95% CI: 1.35, 4.90), and thrombocytopenia (AHR= 2.18: 95% CI: 1.20, 3.96) were found to be significant predictors of acute kidney injury among patients admitted to ICU. Conclusion and recommendation: The overall incidence rate of acute kidney injury among patients admitted to the intensive care unit was lower as compared to studies conducted in developed countries. Sepsis, diabetes mellitus, congestive heart failure, anemia, vasopressors and thrombocytopenia were predictors of acute kidney injury. Therefore, health care providers shall give special emphasis and close follow-up for those patients to reduce the risk of AKI.