Abstract:

Acute kidney injury, formerly called acute renal failure, is an abrupt decline in renal function, clinically manifesting as a reversible acute increase in nitrogen waste products measured by blood urea nitrogen and serum creatinine levels. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information through multidisciplinary joint conferences and journals, and improved translation of knowledge from preclinical research. Objective of the study is to determine prevalence, risk factors and primary outcome of AKI for the patients admitted at BMC from 2012 to 2017. The methodology used in this study was a retrospective, which was done at BMC referral hospital in Mwanza. The target population of this study were all men and women patients admitted with AKI at BMC from 2012 to 2017. Those who met the inclusion criteria was enrolled using a detailed checklist and analysis was done using the SPSS version 20.

Research finding was 0.7% (n=100) patients diagnosed with Acute Kidney Injury from 2012 to 2017, whereas 14286 patients were admitted in the medical wards during this period. The commonest Pre-renal cause of AKI was congestive cardiac failure by 36% followed by infection / septic shock 33%, Hypovolemic shock 29% and other causes 24%. However, the Intrinsic cause of AKI, Herbal intoxication was leading by 22%, followed by Glomerulonephritis 15%, and drug induced 7%, Rhabdomyolysis 5% and Pyelonephritis 3%. Post-renal cause of AKI, Prostate enlargement was leading by 12%, followed by Bladder tumor 8% and Kidney stones 4%. The common associated co morbid risk factor was infection by 43%, followed by Hypertension 36%, AKI on CKD 32%, chronic heart failure 30%, herbal use 27%, diabetes 23%, tumors 12%, renal stones 10% and autoimmune disease 1%. The overall mortality of patients was high by 55% and 45% patients were discharged.

This concludes that the identification of risk factors that predispose to AKI is a crucial aspect of care. Application of a 5-dimension risk approach is advisable for adequate flow and sequence of actions. Risk factors in the environment and socioeconomic and/or cultural dimensions must be correctly and precisely identified. Knowledge of modifiable exposures, especially in populations and patients with high-risk profiles, is crucial for prevention, early diagnosis, and/or attenuation of AKI. Political efforts for the modification of risk factors within each dimension in conjunction with increasing awareness among care providers is likely to significantly affect patient outcomes.