Acute kidney injury among medical and surgical in-patients in the Cape Coast Teaching Hospital, Cape Coast, Ghana: a prospective cross-sectional study

Abstract

Background: Acute kidney injury (AKI) is a syndrome associated with high morbidity, mortality and high hospital costs. Despite its adverse clinical and economic effects, only a few studies have reported reliable estimates on the incidence of AKI in sub-Sahara Africa. We assessed the incidence and associated factors of AKI among medical and surgical patients admitted to a tertiary hospital in Ghana.
 Methods: A prospective cross-sectional study was conducted among one hundred and forty-five (145) consecutive patients admitted to the medical and the surgical wards at the Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana from April 2017 to April 2018. Socio-demographic and clinical information were collected using structured questionnaires. AKI was diagnosed and staged with the KDIGO guideline, using admission serum creatinine as baseline kidney function.
 Results: The mean age of the study participants was 46.6±17.7 years, whilst the male:female ratio was 68:77. The overall incidence of AKI among the participants was 15.9% (95% CI: 10.33 – 22.84%). Stage 1 AKI occurred in 56.5% of the par- ticipants, whilst stages 2 and 3 AKI respectively occurred among 4.1% and 2.8% of respondents. About 20% of the partic- ipants in the medical ward developed AKI (n= 15) whilst 12% of those in surgical ward developed AKI (n= 8). Among the participants admitted to the medical ward, 60.0%, 26.7% and 13.3% had stages 1, 2 and 3 AKI respectively. Whilst 50.0%, 25.0% and 25.0% respectively developed stages 1, 2 and 3 AKI in the surgical ward. Medical patients with AKI had hyper- tension (40%), followed by liver disease (33.3%); 37.5% of surgical inpatients had gastrointestinal (GI) disorders.
 Conclusion: The incidence of AKI is high among medical and surgical patients in-patients in the CCTH, Ghana, with hy- pertension and liver disease as major comorbidities.
 Keywords: Acute kidney injury; KDIGO; medical; surgical; hypertension; liver disease.

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

“…We estimated the prevalence of hypertension from 16 studies. Pooled prevalence was 24.4% (95% CI: 16.7–34.2; 14 studies) 39 , 49 , 50 , 52 , 55 , 64 , 66 , 67 , 69 – 71 , 79 , 84 , 85 in medical wards, and 31.5% (95% CI: 26.4–37.1; two studies) 58 , 80 in emergency departments. A high degree of heterogeneity in prevalence estimates was observed in the medical setting (95% PI: 4.1–71.1; I 2 : 99.7%).…”

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“…We have several papers on injury: traumatic spinal cord injury and clinical complications; 38 acute kidney injury among medical and surgical in-patients in Ghana; 39 mortality and its determinants after fragility hip fractures from Egypt 40 ; and risk factors for childhood injuries in Tanzania. 41 ending with a study of sports medicine practices for athletes in Uganda.…”