Effect of Acute Kidney Injury on In-hospital Mortality in Non-critical Medical Patients in a Sub-Saharan African Country

Abstract

ABSTRACTBackgroundAKI is a major global public health problem that affects millions of people each year and has been linked to poor prognosis in critically ill patients. As being a common complication in hospitalized patients, understanding its effect on non-critical patients is equally crucial, but there is a paucity of knowledge in this area, particularly in Africa. Therefore, the aim of this study was to assess the effect of AKI on in-hospital morality in non-critical medical patients admitted to a large tertiary hospital in Ethiopia.MethodsA retrospective cohort study of 319 non-critical medical patients (113 with AKI and 206 without AKI) admitted between July 2019 and January 2022 was conducted. The in-hospital mortality rate was estimated using incidence density with a 95% CI. The two groups’ comparability was assessed using chi-square and Fisher’s exact tests. The effect of AKI on in-hospital mortality was analyzed using a log binomial regression model with a p-value of ≤ 0.05 determining a significant effect, and the effect was measured using adjusted relative risk (ARR) and its 95% CI.ResultsThe in-hospital mortality rate was 6.8 per 1000 person-days of observation (95% CI=4.9-9.4). AKI did not show a significant effect on in-hospital mortality (ARR = 0.72, 95% CI=0.30-1.71, p=0.450). On the other hand, sepsis was found to be a significant predictor, with over a threefold increase in risk of in-hospital mortality (ARR=3.47, 95% CI=1.60-7.52, p=0.002).ConclusionWith early detection and proper management, non-critical patients with AKI can have a similar prognosis as those without AKI, unlike the critical setting. However, sepsis was found to be a significant predictor of in-hospital mortality implying the need to pay special attention to the management of these cases.