TY  - BOOK
AU  - Taibali Saifuddin Abderasul
AU  - Samuel Kalluvya
AU  - Robert Peck
TI  - Prevalence, Associated Factors and Outcome of Renal Dysfunction Among Adults Admitted in Medical Ward at Bugando Medical Centre
PY  - 2014///
CY  - Mwanza, Tanzania:  
PB  - Catholic University of Health and Allied Sciences CUHAS - Bugando
KW  -  
N2  - Abstract:

Background: The global increase in the incidence and prevalence of renal dysfunction is related to the global increase in the prevalence of diabetes mellitus, hypertension, human immunodeficiency virus, obesity, and aging. Most patients with end stage renal disease in low and middle-income countries die because they cannot access renal replacement therapy, due to its high cost and lack of availability. There is very little data available on the prevalence, predictors and outcome of renal dysfunction in adults admitted to hospitals in sub-Saharan Africa, a group known to be high risk for this condition.

Objective: The objective of this study was to determine the prevalence, associated factors, and predictors of 3 month mortality and outcomes of renal dysfunction in adults admitted to the medical wards of Bugando Medical Centre.

Methodology: This was both an analytical cross-sectional study (for determining prevalence and predictors) and a prospective cohort study (for determining outcomes) among inpatients admitted to the medical ward at Bugando Medical Centre. For each patient, clinical features of renal dysfunction were assessed, and blood and urine tests were enrolled for assessment of renal function. All enrolled subject was followed up with a phone call at 3 months. Data was analyzed using STATA version 13.

Results: A total of 647 patients were enrolled into the study. The prevalence of renal dysfunction was 191 (29.6%). Of 62 (34.8%) patients with renal dysfunction who survived until 3 months, the prevalence of acute kidney injury was 30.5% and of chronic kidney disease was 69.5%. factors found to be significantly associated with renal dysfunction were increasing age, low socioeconomic status, a history of hypertension, heart failure or diabetes, high blood pressure on admission, meeting Framingham criteria for heart failure or diabetes, high blood pressure on admission, obesity and abnormal urine dipstick. Predictors of in hospital mortality were low socioeconomic status, loss of consciousness during admission and systolic hypotension. Predictors of 3 month mortality were low socioeconomic status, loss of consciousness during admission and RBCs in urine. In hospital and 3 month mortality in patients with kidney disease were 73/191 (38.2%) and 104/178 (58.8%) respectively.

Conclusion and Recommendation: The prevalence of renal dysfunction among medical inpatients in our hospital setting is high, and patients with renal dysfunction at our hospital have very high in hospital and 3 month mortality. There is a need for new interventions to address these problems at our centre, such as renal replacement therapy for patients with acute kidney injury and end stage renal disease patient at our centre or a renal disease prevention programme

ER  -