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Jun 26, 2024Keywords:
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Incidence, predictors and early outcomes of acute kidney injury among patients undergoing abdominal surgery at Bugando Medical Centre, Mwanza, Tanzania
Abstract
Background: Acute kidney injury (AKI) is a frequent occurrence following major surgery and is independently associated with high morbidity and mortality. Data regarding AKI following abdominal surgery is limited in the sub-Saharan Africa and Tanzania in particular. This study aimed to determine the incidence, predictors and early outcome of AKI among patients undergoing abdominal surgery at Bugando Medical Centre (BMC).
Methods: This was a longitudinal study to determine the incidence, predictors and early outcome of acute kidney injury among patients undergoing abdominal surgery at BMC between March 2022 and July 2022.
Results: A total of 172 patients were studied (M: F= 1.1: 1). The overall median age of patients at presentation was 34 years. Forty-six (26.7%) patients developed AKI postoperatively. Among the patients who had AKI, 30(65.2%) were classified as KDIGO stage1, 12 (20.1%) as stage 2 and 4 (8.7%) as stage 3. On multivariate analysis, the age ≥45 years (p=0.036), pre-existing medical illness (p=0.015), pre-existing renal dysfunction (p= 0.007), duration of surgery (p=0.007) and emergency surgery (p= 0.001) were the main predictors of postoperative AKI. The overall median length of hospital was 8.7 days and the overall mortality rate was 5.8%. The mortality rate among patients with AKI was significantly high compared to patients without AKI (15.2% v/s 2.4%; p= 0.020). Postoperative AKI was independently significantly associated with prolonged length of hospital stay (p= 0.001) and mortality (p=0.020). Recovery was observed in 63% of patients who developed post-operative AKI.
Conclusion: AKI incidence is high among patients undergoing abdominal surgery at BMC and is associated with high mortality and increased LOS. Prompt identification and aggressive treatment of postoperative AKI risk factors offer the potential of reducing the burden of AKI in this group of patients.
