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

Background: The prevalence and mortalities due to renal diseases is estimated to be high in sub-Saharan Africa. However, 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.
Method: An analytical cross-sectional study was used to determine the prevalence and predictors while prospective cohort design was employed to determine the outcomes. Demographic, clinical and laboratory data were collected from all adult inpatients. For those patients with initial estimated Glomerular Filtration Rate (eGFR) of <60ml/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 69.5% (41/59). 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.
Conclusions: This study has demonstrated a high prevalence of renal dysfunction and associated mortalities. This strongly emphasizes the need to increase awareness among clinicians in Tanzania on renal diseases so as to pro-actively screen, prevent, diagnose and provide early treatment of renal dysfunction among hospitalized patients.

Keywords
renal dysfunction; kidney; injury; disease; prevalence; outcomes; Tanzania