Factors associated with acute kidney injury recovery in a tertiary hospital in Ghana: a prospective study

Introduction: acute kidney injury (AKI) is a challenging problem in developing countries due to late presentation of its victims to health care facilities. Data on the pattern of AKI, its outcome and factors associated with its recovery is scanty in developing countries therefore impeding AKI management. Aim: to study AKI recovery rate and its associated factors.Methods: an observational study conducted from September 2013 to June 2014 at Korle-Bu Teaching Hospital (KBTH). Participants were adults, admitted with AKI at KBTH. Kidney Disease: Improving Global Outcomes (KDIGO) criteria was used to diagnose and stage AKI.Results: mean age (SD) of the participants was 41.9 (± 19.2) years. About a third of the patients (34.6%) were less than 29 years with 30-39 years and 40-60 years constituting 23.0% and 23.6% respectively. Females were in the majority (56.0%). AKI stages I, II and III accounted for 11.0%, 6.8% and 70.7% respectively. Majority, 82.2% of the patients recovered their kidney function. Stage III AKI was significantly associated with decreasing odds of recovery [OR = 0.4, 95%CI = 0.4-2.6, p = 0.002]. In addition, normal blood sodium was associated with recovery from AKI [OR, 95%CI = 2.3, (1.1-5.3), p = 0.043]. Almost half (45.5%) presented with fever whereas 32.5% and 22.5% presented with peripheral oedema and pulmonary oedema respectively.Conclusion: the study demonstrated high kidney function recovery following AKI. Dominant clinical features were fever, peripheral and pulmonary oedema. Advanced stage was associated with poor recovery whereas normal serum sodium level improves kidney function recovery

Atteintes renales chez l'adulte drepanocytaire ivoirien

Introduction. L'atteinte renale est precoce et frequente chez le drepanocytaire. Elle a ete peu decrite chez les drepanocytaires africains. L'objectif de notre etude etait de decrire les aspects epidemiologique; clinique; therapeutique et evolutif des manifestations renales observees chez les adultes drepanocytaires ivoiriens. Population et methodes. Etude retrospective descriptive monocentrique incluant tout patient drepanocytaire ayant une nephropathie tubulaire; interstitielle; glomerulaire ou vasculaire. Resultats. Vingt un cas ont ete colliges. Il s'agissait de 13 hommes et 8 femmes ages en moyenne de 26;42 ans; 17 patients etaient porteurs de l'hemoglobine SS. L'atteinte renale etait tubulaire dans 6 cas; interstitielle dans 3 cas et glomerulaire dans 9 cas. 3 patients avaient une hypertension arterielle. On notait 15 cas d'insuffisance renale aigue et 6 cas d'insuffisance renale chronique. Le traitement a comporte la transfusion de concentres erythrocytaires chez 17 patients; l'utilisation d'inhibiteur de l'enzyme de conversion chez 12 malades et l'epuration extra renale etait indiquee dans 11 cas. 7 patients ont pu beneficier du traitement de suppleance. L'evolution a ete marquee par la guerison de 6 patients; 3 malades sont sortis et perdus de vue et 5 malades etaient vus en consultation de nephrologie. 7 patients sont decedes. Conclusion : L'atteinte renale est dominee par des manifestations glomerulaires compliquees d'une insuffisance renale chronique. Nous recommandons la recherche systematique d'une proteinurie a la bandelette urinaire et l'evaluation de la fonction renale dans le suivi du patient drepanocytaire et au cours des crises vaso-occlusives