Admission Trends and Clinical Outcomes of Chronic Kidney Disease at Tamale Teaching Hospital, Ghana: A Four-Year Retrospective Study

Abstract Background Chronic kidney disease (CKD) is a major contributor to global morbidity and mortality, with hospitalization outcomes shaped by a range of sociodemographic and clinical factors. In Ghana, particularly at the Tamale Teaching Hospital (TTH), limited data exist on the trends, outcomes, and predictors of in-hospital mortality and Discharge Against Medical Advice (DAMA) among patients with CKD. Aim This retrospective study aimed to describe the characteristics of CKD patients, assess admission outcomes, and identify factors associated with in-hospital mortality and DAMA. Methods A retrospective review of medical records was conducted for 829 CKD patients admitted between January 2021 and December 2024. Data were extracted on sociodemographic characteristics, admission details, outcomes, and insurance status. Descriptive statistics summarized trends across the years. Logistic regression was used to identify factors associated with in-hospital mortality and DAMA. Analysis was performed using R software (version 4.2.3). Results The majority of patients were aged ≥ 41 years (52.2%) and male (54.5%). Most were unemployed (54.9%) and had no formal education (71.4%). Most admissions occurred through the Accident and Emergency ward (65.3%). DAMA was the most common outcome (79.7%), followed by mortality (18.3%). Mortality increased annually, reaching 28.0% in 2024. Logistic regression showed that admission through the Accident and Emergency ward (Adjusted OR = 1.82; p = 0.02) and lack of NHIS coverage (Adjusted OR = 1.93; p = 0.01) were significantly associated with in-hospital mortality. DAMA was more likely among patients aged 21–40 years and those with NHIS coverage (Adjusted OR = 1.76; p = 0.01), but less likely among those admitted through the Accident and Emergency ward (Adjusted OR = 0.57; p = 0.02). Conclusion Hospitalization outcomes for CKD patients at TTH are suboptimal, with high rates of DAMA and rising mortality over time. Admission ward and NHIS coverage significantly influenced both mortality and DAMA. Targeted interventions are needed to address patient education, health financing, and care quality to improve CKD outcomes.