The incidence, risk factors, and outcomes of acute kidney injury in the intensive care unit in Sudan

Magboul, Salma Mohammed; Osman, Bashier; Elnour, Asim Ahmed

Background There is a paucity of studies in acute kidney injury in the intensive care unit, particularly in Sudan. Objectives The current study has estimated the incidence; risk factors and outcomes of subjects with acute kidney injury developed during admission to the intensive care unit at Fedail Hospital, Khartoum, Sudan. Methodology This was a cross-sectional study conducted in the intensive care unit during the period from July 2018 to June 2019. The data was collected from the clinical profiles of all adult subjects’ who have met the published criteria for acute kidney injury. Analysis of association (Chi square test χ(2)) and multivariate logistic regression were used to analyze data. Main outcome measure The development of acute kidney injury during the subjects’ stay in the intensive care unit, length of hospital stay and death. Results From a total of 187 subjects admitted to the intensive care unit; only (105, 56.2%) have met the inclusion criteria (mean age was 61 ± 3.5 years). The main finding of the study was the high incidence of acute kidney injury 39%. The major significant predictors for the development of acute kidney injury with respective odds ratio (OR) were: sepsis (OR 7.5 [95% CI 3–19.7]; P .001); hypovolemia (OR 5.1 [95% CI 2–15.7]; P .001); chronic cardiovascular diseases (OR 3.4 [95% CI 1.2–9.4]; P .017); age > 60 years (OR 2.7 [95% CI 1.2–6.3]; P .018); diabetes mellitus (OR 2.6 [95% CI 1.2–6]; P .02); hypertension (OR 2.4 [95% CI 1.2–5.4]; P .028); and renal replacement therapy (OR 0.2 [95% CI 0.15–0.3]; P .001). The length of hospital stay within the AKI cohort was (6.7 ± 3.8; [range 2–17]) and the mortality rate was (36, 87.8%). Conclusion The major significant predictors for the development of acute kidney injury in the intensive care unit were: sepsis; hypovolemia; chronic cardiovascular diseases; age > 60 years; diabetes mellitus; hypertension; and renal replacement therapy. Sepsis and hypovolemia were common etiologies for acute kidney injury post-admission to the intensive care unit. Acute kidney injury was associated with increased length of hospital stay and a very high absolute mortality rate.