Key result
The overall prevalence of acute kidney injury in patients admitted with acute decompensated heart failure was 25.1%, and was independently associated with older age, diabetes, hypertension, sepsis, loop diuretic use, and previous AKI.
Why the study?
AKI frequently complicates ADHF hospitalizations with worse outcomes, but data on its magnitude and associated factors in resource-limited settings such as Ethiopia are limited.
Cross-Sectional (n=239)
No
In a resource-limited setting in Ethiopia, one-quarter of patients admitted with acute decompensated heart failure developed acute kidney injury, highlighting the need for risk stratification using clinical factors like older age, diabetes, hypertension, and sepsis.
BACKGROUND: Heart failure often leads to hospitalization and can directly impact other organs, such as the kidneys. Acute kidney injury (AKI) is a common complication in patients hospitalized for acute decompensated heart failure (ADHF) and is associated with worse outcomes. However, there are limited data on the magnitude of AKI among hospitalized ADHF patients in resource-limited settings such as Ethiopia. This study sought to determine the prevalence of AKI and the factors associated with AKI in ADHF patients in Northwest Ethiopia. METHOD: A hospital-based cross-sectional study was conducted at the University of Gondar Hospital in Northwest Ethiopia from June 1 to September 30, 2022. A total of 239 participants were included using consecutive sampling. Demographic information was collected through patient interviews, and relevant clinical and laboratory data were obtained from the patients' medical records. The data were analyzed using STATA version 15.0. Bivariate and multivariate logistic regression analyses were carried out to identify independently associated factors of AKI among patients with ADHF. A P value < 0.05 was considered to indicate statistical significance. RESULTS: The overall prevalence of AKI in ADHF patients was 25.1% (CI = 19.98-31.03). Older age ≥ 60 years(AOR = 2.95, 95%CI:1.34-6.21), diabetes mellitus (AOR = 9.55,95%CI:2.68-33.99),Hypertension (AOR = 2.34,95% CI:1.08-5.07), sepsis (AOR = 2.13,95%CI:1.09-4.8), use of loop diuretics (AOR = 4.03,95%CI:1.86-8.69) and previous history of AKI (AOR = 11.56,95%CI:4.02-33.26) were independently associated with the occurrence of AKI among ADHF patients. CONCLUSION: A quarter of the patients admitted with ADHF developed AKI. Older age; comorbid diabetes mellitus, hypertension, or sepsis; a previous history of AKI; and the use of loop diuretics were associated with the occurrence of AKI. Such clinical characteristics available at hospital admission can be used to identify patients at increased risk for developing AKI.
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Mezgebu et al. (2024) conducted a cross-sectional in Acute decompensated heart failure (n=239). The overall prevalence of acute kidney injury in patients admitted with acute decompensated heart failure was 25.1%, and was independently associated with older age, diabetes, hypertension, sepsis, loop diuretic use, and previous AKI.
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