Acute kidney injury and its associated factors among patients with acute decompensated heart failure admitted to the university of Gondar Hospital, Northwest Ethiopia: a hospital-based cross-sectional study

Background: Heart failure often leads to hospitalization and can directly impact other organs, such as the kidneys. Acute kidney injury (AKI) is a common complication in patients hospitalized for acute decompensated heart failure (ADHF) and is associated with worse outcomes. However, there are limited data on the magnitude of AKI among hospitalized ADHF patients in resource-limited settings such as Ethiopia. This study sought to determine the prevalence of AKI and the factors associated with AKI in ADHF patients in Northwest Ethiopia.

Method: A hospital-based cross-sectional study was conducted at the University of Gondar Hospital in Northwest Ethiopia from June 1 to September 30, 2022. A total of 239 participants were included using consecutive sampling. Demographic information was collected through patient interviews, and relevant clinical and laboratory data were obtained from the patients' medical records. The data were analyzed using STATA version 15.0. Bivariate and multivariate logistic regression analyses were carried out to identify independently associated factors of AKI among patients with ADHF. A P value < 0.05 was considered to indicate statistical significance.

Results: The overall prevalence of AKI in ADHF patients was 25.1% (CI = 19.98-31.03). Older age ≥ 60 years(AOR = 2.95, 95%CI:1.34-6.21), diabetes mellitus (AOR = 9.55,95%CI:2.68-33.99),Hypertension (AOR = 2.34,95% CI:1.08-5.07), sepsis (AOR = 2.13,95%CI:1.09-4.8), use of loop diuretics (AOR = 4.03,95%CI:1.86-8.69) and previous history of AKI (AOR = 11.56,95%CI:4.02-33.26) were independently associated with the occurrence of AKI among ADHF patients.

Conclusion: A quarter of the patients admitted with ADHF developed AKI. Older age; comorbid diabetes mellitus, hypertension, or sepsis; a previous history of AKI; and the use of loop diuretics were associated with the occurrence of AKI. Such clinical characteristics available at hospital admission can be used to identify patients at increased risk for developing AKI.