Mortality and associated factors in End-Stage Renal Disease patients admitted at the Kenyatta National Hospital from 2017 to 2021

Abstract

Background: End Stage Renal Disease (ESRD) presents a challenge to global healthcare systems. While there have been improvements in treatment modalities available, the mortality associated with ESRD is still high.
Objective: To determine the mortality and associated factors among ESRD patients admitted at the Kenyatta National Hospital (KNH) between 2017 and 2021.
Methodology: A retrospective study design using medical records of 252 patients obtained through simple random sampling. Data of in-patients with ESRD at KNH from 2017-2021 was extracted from records. Data on socio-demographic and disease-related factors was also extracted from the records. Stata 17 software was used for data analysis. The main study outcomes were death or survival at discharge.
Results: Sixty percent of the patients were males and the median age was 52 years. Over the 5 years, 33% of the patients died during admission. Older age (>50 years), male gender, rural residence, lack of medical insurance, hypertension as an aetiology and comorbidity, unknown cause of ESRD, using a catheter for dialysis access, eGFR at admission, and hyperkalemia were associated with higher mortality with p values ≤ 0.05.
Conclusion: Mortality among ESRD patients on haemodialysis admitted at KNH is high. The focus should be on prevention and improving access to kidney transplantation services. For patients on haemodialysis, modifiable risk factors associated with mortality such as catheter access as a route for dialysis and hyperkalemia at admission should be identified early.