Renal dysfunction among adult patients in Mwanza, Tanzania: prevalence, outcomes and associated factors

Abstract

Background: The prevalence and mortalities due to renal diseases is estimated to be high in sub-Saharan Africa. Little is known about these conditions among the hospitalized adult-patients in Tanzania. The objective of this study was to determine the magnitude, associated factors and outcomes of renal dysfunction among the inpatients at Bugando Medical Centre in Mwanza, Tanzania.

Methods: This was both analytical cross section (for determining the prevalence and predictors) and prospective cohort (for determining the outcomes) study. Demographic, clinical and laboratory data were collected from all adult inpatients. For those patients with initial estimated Glomerular Filtration Rate (eGFR) of <60mls/min/1.73m², a repeat creatinine test was done after 3-months to diagnose the chronic kidney disease.

Results: Out of 637 patients, 48.2% were females and the median age was 45 years. Twenty-eight percent of the study population had renal dysfunction. The prevalence of Chronic Kidney Disease was 41/59 (69.5%).  The odds of having renal dysfunction was strongly predicted by older age (p=0.009), female sex (p=0.004), heart failure (p<0.001), diabetes (p=0.04), decreased urine output (p<0.001) and proteinuria (p=0.004). Mortality, both in-hospital (3.23 [2.19–4.74] p<0.001) and at 1-month post-discharge (3.07[2.13-4.41], p<0.001) was found to be significantly higher in patients with renal dysfunction.

Conclusion: Our study has demonstrated a high magnitude of renal dysfunction and associated mortalities. This strongly emphasizes the need to increase awareness among clinicians in sub-Saharan Africa on renal diseases so as to pro-actively screen, prevent, diagnose and early treatment of renal dysfunction among hospitalized patients.