Date of Award
6-2022
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Robert Mvungi
Second Supervisor/Advisor
Fatma Bakshi
Third Supervisor/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
Recommended Citation
Hooda, F. (2022). Prevalence & factors associated with acute kidney injury in patients undergoing percutaneous coronary intervention at a tertiary healthcare facility in Tanzania (Unpublished master's dissertation). Aga Khan University, East Africa.