Teuwafeu Denis Georges, Ayonghe Arisha, Mbua Ronald Gobina, Nkoke Clovis, Mahamat Maimouna, Divine Mokake, Ashuntantang Gloria
Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Buea Regional Hospital, Buea, Cameroon.
Pan Afr Med J. 2025 Jan 13;50:22. doi: 10.11604/pamj.2025.50.22.31772. eCollection 2025.
there is a paucity of data on the burden of acute kidney injury (AKI) in non-renal medical and surgical admissions where renal function monitoring is not routinely done. This study evaluated the incidence and outcomes of AKI in non-renal medical and surgical admissions at risk of AKI.
we prospectively assessed non-renal medical and surgical admissions at the Buea Regional Hospital during a 6-week period for AKI risk factors. Consenting participants with AKI risk factors were then screened for AKI using the modified KDIGO (Kidney Disease Improving Global Outcomes) criteria. We excluded patients with a history of Chronic Kidney Disease (CKD), confounders of serum creatinine (e.g. cimetidine, limb amputees), and those without a second serum creatinine value. Modifiable AKI risk factors were corrected and patients with AKI were presented to the nephrologist. Patients were followed up until hospital discharge or death. The outcome measures were the presence of AKI, need and access to dialysis, renal recovery on discharge, for both participants with and without AKI, death, and length of hospital stay.
a total of 165 (41.6% males) participants were included, and six were excluded. The mean (SD) age was 50.7 (17.29) years. Hypertension 43 (26.06%), obesity 28 (16.97%), Human Immunodeficiency Virus (HIV) 25 (15.15%), and diabetes mellitus 22 (13.33%) were the most frequent co-morbid conditions. Sepsis 110 (66.67%) and volume depletion 69 (41.82%) were the most common AKI risk factors. The incidence of AKI was 27.3% (n=45), with 35.6% (n=16) of these in KDIGO AKI stage 3. A total of 4 (8.9%) required dialysis with a 100% access rate. The in-hospital mortality was 6.6% (11/165), with the rate significantly higher in the AKI group (17.78%) compared to the non-AKI group (2.50%) (HR: 2.3, CI: 1.48-2.80, p=0.001). Complications of AKI accounted for 27.27% (3/11) of all causes of death. The median length of hospital stay was longer in the AKI group (11(6-15)) without a statistically significant difference compared to the non-AKI group (8(6-12.5)) (HR: 1.04, CI: 0.99-1.09, p=0.103). Renal recovery on discharge was complete in 62.2% of survivors.
the incidence of AKI is high in non-renal medical and surgical admissions at the Buea Regional Hospital and it is associated with a high mortality.
在非肾脏内科和外科住院患者中，关于急性肾损伤（AKI）负担的数据较少，这些患者通常不进行常规肾功能监测。本研究评估了有AKI风险的非肾脏内科和外科住院患者中AKI的发病率和预后。
我们在6周期间对布埃亚地区医院的非肾脏内科和外科住院患者进行前瞻性评估，以确定AKI风险因素。然后，使用改良的KDIGO（改善全球肾脏病预后组织）标准对有AKI风险因素且同意参与的患者进行AKI筛查。我们排除了有慢性肾脏病（CKD）病史的患者、血清肌酐的混杂因素（如西咪替丁、肢体截肢者）以及没有第二次血清肌酐值的患者。对可改变的AKI风险因素进行纠正，并将AKI患者转诊给肾病科医生。对患者进行随访直至出院或死亡。结局指标包括AKI的存在情况、透析需求及可及性、出院时肾功能恢复情况（包括有AKI和无AKI的参与者）、死亡情况以及住院时间。
共纳入165名参与者（41.6%为男性），排除6名。平均（标准差）年龄为50.7（17.29）岁。最常见的合并症为高血压43例（26.06%）、肥胖28例（16.97%）、人类免疫缺陷病毒（HIV）感染25例（15.15%）和糖尿病22例（13.33%）。脓毒症110例（66.67%）和容量不足69例（41.82%）是最常见的AKI风险因素。AKI的发病率为27.3%（n = 45），其中35.6%（n = 16）处于KDIGO AKI 3期。共有4例（8.9%）需要透析，透析可及率为100%。住院死亡率为6.6%（11/165），AKI组的死亡率（17.78%）显著高于非AKI组（2.50%）（风险比：2.3，可信区间：1.48 - 2.80，p = 0.001）。AKI并发症占所有死亡原因的27.27%（3/11）。AKI组的中位住院时间较长（11（6 - 15）），与非AKI组（8（6 - 12.5））相比无统计学显著差异（风险比：1.04，可信区间：0.99 - 1.09，p = 0.103）。62.2%的幸存者出院时肾功能完全恢复。
布埃亚地区医院非肾脏内科和外科住院患者中AKI的发病率较高，且与高死亡率相关。
