IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 3 Ver. VII (Mar. 2015), PP 55-59 www.iosrjournals.org DOI: 10.9790/0853-14375559 www.iosrjournals.org 55 | Page Acute Kidney Injury in Hospitalized patients at the University of Calabar Teaching Hospital: An aetiological and outcome study Emmanuel Edet Effa 1,2 , Henry Ohem Okpa 1,2 , Patrick Ntui Mbu 2 , Ezoke James Epoke 2 , Daniel Emmanuel Otokpa 2 1Renal Unit, Department of Internal Medicine, College of Medical Sciences, University of Calabar, Nigeria 2Department of Internal Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria Abstract: Background : The burden of Acute Kidney injury in developing countries especially in Sub- Saharan Africa is enormous. The morbidity and mortality appears to be rising despite the availability of dialysis therapy in some parts of Africa. Objective: To determine the causes and the factors that influence outcome of acute kidney injury in hospitalized patients at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Design : This was a prospective study of patients with acute kidney injury admitted in UCTH, Calabar over a 12 month period from January 2014 to December 2014. Data was analysed using SPSS version 18. Results : A total of 1138 patients were admitted with 42 of them developing AKI giving an incidence rate of 3.6%. Eighteen (42.9%) of the participants were males while 24 (57.1%) were females. Age ranged from 11 to 81 years with a mean age of 44.2±17.32 years. The common causes of AKI were septicaemia 20 (47.6%), malignant phase hypertension 7 (16.7%) and hypovolaemia 4 (9.5%).Other causes accounted for the remaining 11 (26.1%). Thirty one (73.8%) had co-morbidities and hypertension 12 (38.7%) was the commonest co-morbid condition. For outcome, 29 (69.0%) of the patients were discharged home while 13 (31.0%) of them died in the hospital. Survivors had more dialysis sessions than those that died (P < 0.05). Conclusion : Septicaemia is the commonest cause of AKI in our centre. In-hospital mortality rate is high. The severity of AKI at presentation and lack of dialysis therapy are contributory factors. Keywords – Acute kidney injury, Aetiological, Factors, Outcomes, Teaching. I. Introduction Acute kidney injury (AKI), previously referred to as acute renal failure, is defined as a sudden decline in kidney function, with falling glomerular filtration rate and the inability to regulate acid, electrolyte balance and to excrete waste and fluid [1,2]. Acute kidney injury (AKI) in adults is a common cause of hospitalization, associated with high morbidity and mortality especially in developing countries. Community acquired AKI is more frequently encountered in developing countries, while hospital-acquired AKI is more prevalent in developed countries [2, 3]. Community-acquired AKI is responsible for about 1.4–1.9 percent of medical admissions in most reports from Nigeria [4–6], while hospital-acquired AKI is responsible for about 1 percent of hospital admission in most countries in Europe and North America [2, 3]. Some cases are difficult to categorise, due to the complex nature of different underlying conditions. Acute Kidney Injury in humans is a heterogeneous condition as it runs a variable course largely determined by the cause, the severity, comorbid conditions and whether or not renal replacement therapy is administered. Despite advances in the understanding of the pathophysiology of AKI and its management, mortality rates have remained high [7]. Mortality varies between 40 – 50% in hospitalized patients and 70 – 90% among patients admitted into intensive care units [7-10]. There is an increasing use of Renal Replacement Therapy (RRT) in the form of intermittent haemodialysis (IHD) or continuous therapies (CRRT) for AKI. Delay in initiating dialysis has been shown to contribute to poor outcome with some studies even suggesting improved outcome with early initiation of dialysis treatment [10,11]. In spite of this, in- hospital mortality rates remain high even in the developed countries of Europe and North America [12, 13]. Renal Replacement Therapy in the form of haemodialysis is now more commonly available in Nigeria. However, the high cost of this service and its accessibility (majority are in urban areas) means patients who otherwise would survive eventually die. Currently in Nigeria, there is no policy on subsidy of renal replacement therapy (RRT) and the public sector administered National Health Insurance Scheme does not cover any form of RRT. Most published studies in Nigeria have described the causes of AKI, but not much is known regarding the factors that influence outcomes of AKI. In our centre located in southern Nigeria, where specialist renal care has only become available in the past three years, the paucity of data is even more evident.