Hermine Fouda *,Gloria Ashuntantang ,Marie-Patrice Halle ,François Kaze
Background: The etiologies and outcome of Acute Kidney injury (AKI) in resource-limited countries are largely related to poverty. Outcome is marred by limited access to renal replacement therapy. Recently, partial government funding for hemodialysis in Cameroon and the SYL program have increased access to RRT for AKI in Cameroon. Data on AKI is sparse in Cameroon. We sought to describe the epidemiology of diagnosed AKI amongst patients in a tertiary hospital. Method: We retrospectively reviewed records of patients seen by the nephrology department for AKI over a 13 months period in a tertiary Hospital in Cameroon. Diagnostic of AKI was done using usual criteria. We evaluated access to dialysis, renal recovery at hospital discharge and at 3 months and patient survival at hospital discharge. Results: A total of 108 (61 males, 12 children) patients with AKI were identified among 303 nephrology in-patient consults or admissions during the study period. The mean age was 45.65± 21.23 years. Community acquired AKI was most common (70.4%). Pre-renal, renal and obstructive causes accounted for 26.9%, 62% and 11.1% patients respectively. Infections (n=36, 33.34 %) and toxins (n=21, 19.4 %) were most frequent causes. AKI was pregnancy related in 12 (11%), and malaria-related in 10 (10 %) cases. AKI was multifactorial in 21.3% of patient. Dialysis was indicated in 55 (50.9%) patients but only 30 (27.8%) patients effectively underwent the therapy. Reasons for no access to dialysis were lack of appropriate material and lack of funds. At 3 months, 34 (31.5%) were known dead, 41 (38%) complete renal recovery, 25 (23%) partial recovery and 8 (7.5%) loss to follow-up. No patient was dialysisdependent. Conclusion: Infection and nephrotoxins are the main etiologic factor of AKI. Its prognostic is severe: half of patients need dialysis and third die.
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