Incidence and Outcome of Acute Kidney Injury at TTM Hospital, Samoa – A Prospective Descriptive Study

Incidence and Outcome of Acute Kidney Injury in patients admitted to TTM Hospital – A Prospective Descriptive Study
Chadwick N1, Perman M2, Leaves F3
Researcher Affiliations:
1Internal Medicine Unit, School of Medical Sciences, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva; Fiji
2Internal Medicine Unit, School of Medical Science, College of Medicine Nursing and Health Sciences, Fiji National University, Suva, Fiji
3 Medical Unit, Tupua Tamasese Meaole Hospital, Ministry of Health, Apia, Samoa
Keywords: Acute Kidney Injury, Incidence, Outcome, Mortality. Pacific island countries, Samoa
Introduction
Acute Kidney Injury (AKI), a common global syndrome, characterized by an acute reduction in the glomerular filtration, is associated with considerable morbidity, mortality and high healthcare cost. The key to reduction of unfavorable outcomes is early detection and early treatment.
There is paucity of data on non-critical care settings particularly from Pacific island countries. This study aims to determine the incidence and outcomes of AKI in adult patients admitted to the general wards of a tertiary referral center in Samoa.
Methods
Using the 2012 KDIGO definition of AKI and a cut off serum creatinine level of >200umol/l, adults admitted to the general wards of this single-center during the 6-months study period were prospectively followed up from admission to 3-months post-discharge.
Data collected was entered into Microsoft Excel 2010 and statistically analysis was done using SPSS.
Results
AKI was diagnosed in 114 patients during the study period from 1st December 2019 to 31st May 2020. Of these, eight five (75%) were community acquired. The mean age was 55.8 years and 57.9% were males. The incidence was 26.8 per 1000 admissions and population based incidence was 1880.9 pmp/year. Dehydration (79%) and sepsis (64%) were the 2 main precipitating factors for AKI in this cohort. More than 40% has 2 or more co-morbidities. The in-patient mortality rate was 20.2%. Out of 91 who were alive on discharge, 25% (23/91) died within 3-months post-discharge, 18.7% (17/91) progressed to chronic kidney disease and only 25% had complete resolution.
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Conclusion
This study highlights the high incidence and unfavorable outcomes of acute kidney injury particularly in those who are middle-aged and with co-morbidities. It provides a platform to raise awareness of AKI with the public, government and health care professionals.