Acute Kidney Injury in a Nephrology Setting in Tunisia: A 5-Year Retrospective Study
AKI in Tunisia
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Abstract
Background and hypothesis: Acute kidney injury (AKI) is a common condition associated with significant morbidity and mortality. Data regarding its epidemiological and prognostic characteristics in Tunisia remain limited. This study aimed to describe the clinical features, etiologies, and outcomes of AKI among hospitalised patients and to identify factors associated with renal prognosis, recurrence, and mortality.
Methods: We conducted a retrospective, monocentric, descriptive, and analytical study including all patients hospitalised for AKI in the nephrology department of Hedi Chaker University Hospital (Sfax, Tunisia) over 5 years (2015–2019). Demographic, clinical, biological, radiological, and therapeutic data were collected. Statistical analyses included univariate and multivariate models to identify prognostic factors.
Results: A total of 503 patients were included, with a mean age of 67.9 ± 16.5 years; 52.1% were female. Hypertension (71.4%), diabetes (49.5%), and chronic kidney disease (55.9%) were the most common comorbidities. Functional AKI was the most frequent type, mainly due to hypovolemia. Organic AKI accounted for 46.9% of cases, with acute interstitial nephritis predominating. Hemodialysis was required in 29.8% of patients. At discharge, 27.2% progressed to chronic kidney disease. At 5 years, CKD progression occurred in 40.6% and end-stage kidney disease in 20.3%. AKI recurrence occurred in 23.1%, and mortality was 11.1%. In multivariate analysis, pre-existing chronic kidney disease was independently associated with recurrence and poor renal survival, while hemodialysis was protective against recurrence.
Conclusion: AKI in nephrology settings is associated with a high burden of chronic complications and recurrence. Chronic kidney disease is a major determinant of renal prognosis.
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