Abstract:
Background: Acute kidney injury is an independent risk factor for the development of end-stage renal disease, morbidity and mortality by cardiovascular disease but the progression is not well studied in Ethiopia. Chronic kidney disease poses a huge burden on individual’s as well as country’s healthcare system by adding a huge burden financially in accessing and availing definitive management locally.
Objective: To assess the incidence and predictors of progression of chronic kidney disease after acute kidney injury among patients who are on follow-up at renal clinic of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
Method: An institution-based retrospective follow-up study design was employed to determine the incidence of chronic kidney disease and predictors of its progression among patients who had acute kidney injury at St. Paul’s Hospital Millennium Medical College from January 1, 2015 to October 1, 2021. Systematic random sampling method was used to review medical records of patients who had acute kidney injury during the follow-up period and data was entered into SPSS version 24 for analysis. Frequency and percentage was calculated to describe the study variables and chi-square test was applied to evaluate the association of the study variable with the outcome variable. Further analysis was done using bivariate and multivariable regression analysis to determine the effect of independent variables on the outcome variable.
Result: Among 210 reviewed medical records of patients who has fully recovered from acute kidney injury, 9.5% of them has developed chronic kidney disease with a median follow-up duration of 197.5 days. Patients having repeat admission for acute kidney injury related condition [Adjusted Odds Ratio (AOR) = 0.092; 95% Confidence Interval (CI) = 0.009-0.659], presence of a concomitant heart failure (AOR = 0.219; 95% CI = 0.049-0.971), and development of cardiac arrest during the initial admission (AOR = 0.077; 95% CI = 0.009-0.659) were the factors significantly associated with chronic kidney disease progression (p = 0.000, p = 0.046 and p = 0.019), respectively.
Conclusion: A significant number of patients who had acute kidney injury in a hospital setup will develop chronic kidney disease within a short period of follow-up. Repeat admission for acute kidney injury related condition, having a concomitant heart failure, and development of cardiac arrest were the factors that are significantly associated with the development of chronic kidney disease