Factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda.

INTRODUCTION

Acute kidney injury (AKI) remains one of the complications of severe malaria. Evidence on associated factors and outcomes for patients with complicated malaria and AKI is limited in Rwanda.

AIM

To assess the factors associated with acute kidney injury and outcomes in patients with malaria in a district hospital in Rwanda.

METHOD

A retrospective study design was applied. A census sampling strategy was used to select 122 files of patients admitted as severe malaria patients in 2016-2017. A developed clinical audit form was used to collect data from patients' files. Both descriptive and inferential statistics were used to analyze data.

RESULTS

Among the confirmed severe malaria files, 44% of participants were over 50 years and 52.5% were males. The majority, (91.5%) had community-based health insurance and 16.3% had acute kidney injury. The significant associated clinical factors were dehydration (p=.01), high-grade fever (p=.002), profuse sweating (p=.034), vomiting (p=.043), and diarrhea (p=.025). Of the 20 patients who developed AKI, 55% completely recovered, 15% died and 30% of cases were transferred to the highest facilities for hemodialysis.

CONCLUSION

The existence of AKI among severe malaria patients was evident with some recovering and others dying. There is a need for educating healthcare professionals, mostly at district hospitals about the diagnosis and management of AKI as a result of complicated malaria.