Outcomes of acute kidney injury in a department of internal medicine in ABIDJAN (cote D'IVOIRE)

Yao, Kouamé Hubert; Konan, Serge Didier; Tia, W.M.; Diopoh, Sery Patrick; Moh, Raoul; Sanogo, Sindou

doi:10.1111/nep.13064

Cited by 4 publications

(4 citation statements)

References 35 publications

(37 reference statements)

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“…Indeed, a lack of response to treatment, persistent inflammatory markers and hemodynamic instability in septic patients with AKI are the most prominent prognostic factors. This is in alignment with previous studies from different countries [ 31 , 32 ]. A systematic review in 2013 of 154 large studies that evaluated the world incidence of AKI and associated mortality demonstrated a pooled AKI-associated mortality rates of 23.9% and that rate was declining over time [ 33 ].…”

Section: Discussionsupporting

confidence: 93%

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial

et al. 2022

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Background Treatment with erythropoietin is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury. Methods This is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia defined as hemoglobin < 11 g/dL and acute kidney injury defined as an increase of serum creatinine of ≥ 0.3 mg/dL within 48 h or 1.5 times baseline. One arm received recombinant human erythropoietin 4000 UI subcutaneously every other day (intervention; n = 67) and the second received standard of care (control; n = 67) during the hospitalization until discharge or death. The primary outcome was the need for transfusion; secondary outcomes were death, renal recovery, need for dialysis. Results There was no statistically significant difference in transfusion need (RR = 1.05, 95%CI 0.65,1.68; p = 0.855), in renal recovery full or partial (RR = 0.96, 95%CI 0.81,1.15; p = 0.671), in need for dialysis (RR = 11.00, 95%CI 0.62, 195.08; p = 0.102) or in death (RR = 1.43, 95%CI 0.58,3.53; p = 0.440) between the erythropoietin and the control group. Conclusions Erythropoietin treatment had no impact on transfusions, renal recovery or mortality in acute kidney injury patients with anemia. The trial was registered on ClinicalTrials.gov (NCT03401710, 17/01/2018).

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Section: Discussionsupporting

confidence: 93%

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial

et al. 2022

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“…Indeed, a lack of response to treatment, persistent in ammatory markers and hemodynamic instability in septic patients with AKI are the most prominent prognostic factors. This is in alignment with previous studies from different countries [29,30]. A systematic review in 2013 of 154 large studies that evaluated the world incidence of AKI and associated mortality demonstrated a pooled AKI-associated mortality rates of 23.9% and that rate was declining over time [31].…”

Section: Discussionsupporting

confidence: 87%

Erythropoietin in Acute Kidney Injury (EAKI): a Pragmatic Randomized Clinical Trial

Aoun

Sleilaty

Boueri

et al. 2022

Preprint

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Background Treatment with erythropoietin is well established for anemia in chronic kidney disease patients but not well studied in acute kidney injury.MethodsThis is a multicenter, randomized, pragmatic controlled clinical trial. It included 134 hospitalized patients with anemia defined as hemoglobin <11 g/dL and acute kidney injury defined as an increase of serum creatinine of 0.3 mg/dL within 48 hours or 1.5 times baseline. One arm received recombinant human erythropoietin 4000 UI subcutaneously every other day (intervention; n=67) and the second received standard of care (control; n=67) during the hospitalization until discharge or death. The primary outcome was the need for transfusion; secondary outcomes were death, renal recovery, need for dialysis.ResultsThere was no statistically significant difference in transfusion need (RR=1.05, 95%CI 0.65,1.68; p=0.855), in renal recovery full or partial (RR=0.96, 95%CI 0.81,1.15; p=0.671), in need for dialysis (RR=11.00, 95%CI 0.62, 195.08; p=0.102) or in death (RR=1.43, 95%CI 0.58,3.53; p=0.440) between the erythropoietin and the control group. ConclusionsErythropoietin treatment had no impact on transfusions, renal recovery or mortality in acute kidney injury patients with anemia. The trial was registered on ClinicalTrials.gov (NCT03401710, 17/01/2018).

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“…In one systematic review, only 33% of adults and 64% of children received dialysis when required [ 15 ]. The presence of AKI in Africa is associated with significant mortality [ 3 , 14 , 16 ] and an increased risk of developing chronic kidney disease (CKD) [ 10 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for development of acute kidney injury in hospitalised adults in Zimbabwe

et al. 2020

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Background Acute kidney injury (AKI) is predominantly a disease of low and middle-income countries. Despite this, there is a particular paucity of data regarding AKI in Africa. Most published studies were conducted prior to the most recent Kidney Disease: Improving Global Outcomes (KDIGO) definition of AKI. This prospective, observational, cohort study examines AKI amongst newly admitted acute medical inpatients in a large, urban, tertiary hospital in Harare, Zimbabwe. Methods All newly admitted, adult, medical patients in separate, randomly selected, 24-hour periods were included. Baseline demographic information, comorbidities, nephrotoxic medication use, and reason for admission were recorded on a standardised data capture record. A serum creatinine measurement was performed on all patients at the time of admission and again after 48 hours. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and AKI was defined using the most recent KDIGO definition as an increase in the serum creatinine of greater than 26.5μmol/L within 48 hours, with admission creatinine used as a baseline measurement. Results 253 patients were included in the analysis; 137 patients (54.2%) were female; 100 patients (39.5%) had HIV infection. 36 patients (14.2%) met the KDIGO criteria for AKI during the 48-hour follow-up period. AKI was more common among males (19.8% vs 9.5%; p = 0.019). The AKI group had a higher serum creatinine at presentation than those without AKI (296.5μmol/L vs 91.0μmol/L; p<0.001) and at 48 hours (447.7μmol/L vs 77.1μmol/L; p<0.001). In logistic regression, AKI was related negatively to female sex (OR 0.461, 95% CI 0.211, 1.003; p = 0.051) and positively predicted by the presence of comorbid hypertension (OR 3.292, 95% CI 1.52, 7.128; p = 0.003) and chronic kidney disease (OR 6.034, 95% 1.792, 20.313; p = 0.004). Conclusions KDIGO-defined AKI was common in hospitalised patients in Sub-Saharan Africa and was predicted by male sex, a history of comorbid hypertension and a history of comorbid chronic kidney disease.

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Outcomes of acute kidney injury in a department of internal medicine in ABIDJAN (cote D'IVOIRE)

Abstract: The aetiologies are dominated by infections. The fatality rate is high and its risk factors are advanced age, low haemoglobin level, severe AKI, infection and drug intake. Prevention is essential.

Cited by 4 publications

References 35 publications

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial

Erythropoietin in Acute Kidney Injury (EAKI): a Pragmatic Randomized Clinical Trial

Risk factors for development of acute kidney injury in hospitalised adults in Zimbabwe

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