Date of Award

6-1-2022

Degree Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Advisor

Robert Mvungi

Second Advisor

Fatma Bakshi

Third Advisor

Mariam Noorani

Department

Internal Medicine (East Africa)

Abstract

Background: Acute kidney injury is a potentially fatal but preventable outcome of percutaneous coronary intervention: the most plausible cause being radiocontrast-induced nephropathy; others include: pre-existing renal insufficiency from underlying illnesses and also acute renal insult caused by hypoperfusion from cardiac causes. The prevalence, associated risk factors and outcomes of AKI post-PCI are unclear and unexplored in our setting. Objectives: The study sought to determine the prevalence of acute kidney injury post-percutaneous coronary intervention at The Aga Khan Hospital, Dar es Salaam, Tanzania. Secondary objectives included: factors associated, with and outcomes of acute kidney injury (AKI) post percutaneous coronary intervention (PCI). Methods: A retrospective cross-sectional analytical study was carried out at The Aga Khan Hospital, Dar es Salaam, Tanzania. The study enrolled 227 adults who underwent a percutaneous coronary intervention procedure from August 2014 to December 2020. AKI was defined based on an increase in absolute and rise in percentage creatinine in 2 streams: according to the Acute Kidney Injury Network (AKIN) and Contrast Induced (CI) AKI by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Our study also looked at factors associated with AKI and outcomes of post-PCI AKI. Results: A total of 22 (9.7%) patients sustained AKI. Bivariable and multivariable analysis did not show any statistically significant factors associated with AKI. The in-hospital mortality rate was 9% for patients with AKI versus 2% for patients without AKI. AKI patients had a longer hospital stay, required ICU care and organ support; including haemodialysis. Conclusions: Nearly 1 in 10 patients undergoing PCI are likely to develop AKI. This correlates with worsening morbidity and increased in-hospital mortality. Innovative strategies are required to promptly identify and prevent AKI post-PCI

Download

Share

COinS