Prevalence, Associated Factors, and Outcomes of Acute Kidney Injury in an Intensive Care Unit in Burkina Faso, West Africa
- International Journal of Nephrology and Kidney Failure , 12 (2) : 1-8
Résumé
Introduction: Acute Kidney Injury (AKI) is a common and serious complication in Intensive Care Units (CUs), with particularly high mortality rates in low-income countries. Data on AKI in ICUs are scarce in Burkina Faso. Objective: To determine the prevalence, associated factors and impact on in-hospital mortality of AKI in the ICU of Tengandogo University Hospital in Burkina Faso. Patients and Methods: We conducted a retrospective study from January 1, 2019, to May 31, 2022, in the general ICU of Tengandogo University Hospital, including all adults without pre-existing Chronic Kidney Disease (CKD). AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariate logistic regression analysis was used to identify factors independently associated with AKI and mortality. Results: Of the 311 patients included in the study (median age: 46 years [interquartile range (IQR): 32-61]), AKI occurred in 202 (64.9%). AKI was present on admission in 75.2% of cases and was severe, stage 3 in 49.5%. Factors independently associated with AKI were age ≥ 50 years (p=0.046; OR: 1.7 [95% Cl: 1-2.9]) and mechanical ventilation (p=0.001; OR: 2.6 [95% CI: 1.5-4.5]). Overall in-hospital mortality was 90%, rising to 95.5% in the AKI subgroup. More than half of patients who survived the ICU subsequently died on general wards. Independent predictors of in-hospital mortality were arterial hypertension (p=0.045; OR: 8.9 [95% CI: 1-76.6]), sepsis (p=0.029; OR: 3.5 [95% CI: 1.1-10.7]), and AKI (p=0.001; OR: 4.4 [95% CI: 1.8-10.7]). Conclusion: AKI is highly prevalent, often severe and independently associated with high in-hospital mortality. The significant difference in mortality rates between the ICU and wards highlights the need for intermediate care facilities to improve survival rates in settings with limited resources.
Mots-clés
Acute Kidney Inury Intensie are nit ortality urina Faso est-Africa