Clinical profile and predictors of mortality of patients admitted with renal dysfunction in the internal medicine department at Muhimbili National Hospital-Mloganzila

Abstract

ABSTRACT Background: Renal dysfunction is a major public health problem worldwide, with epidemiological variations from one population to another. It is associated with poor outcomes including high morbidity, high mortality, and long hospital stays especially in low and middle-income countries. Objectives: The study aimed to determine the clinical profile and predictors of mortality of patients admitted with renal dysfunction in the internal medicine department at Muhimbili National Hospital –Mloganzila. Materials and methods: This was retrospective cross-sectional study to investigate the clinical profile and predictors of mortality of patients admitted with renal dysfunction in the Internal Medicine Department at Muhimbili National Hospital Mloganzila between January 2023 to June 2023. The Statistical Program for Social Science (SPSS) version 27 package was used for analysis. Continuous variables were summarized by mean, median, standard deviation, and interquartile range while categorical were summarized by using frequency and percentages. Predictors were determined by multiple logistic regression analysis and variables with p value of less than 0.05 was considered significant. Results: 122 participants of admitted patients had renal dysfunction. The mean age of participants was 50.94±18.46 years. More than half of the study participants were male 66(54.1%). Hypertension was the common comorbidity 76 (62.3%) followed by diabetes mellitus 30 (24.6%) and malignancy 13 (10.7%) of the renal dysfunction patients admitted. 88 (72%) were discharged, while 34 (28%) died. Hemodialysis was performed in 28(23 %) patients. 89 (73%) of patients had anemia, hyponatremia 43 (37.0%), and hyperkalemia 54 (47.8%). Female patients had a reduced risk of mortality (aOR=0.143, 95% CI: 0.040-0.505, P=0.003), no formal education had increased risk of mortality (aOR=4.145, 95% CI: 1.10-17.285, P=0.049). Moreover, patients not on maintenance hemodialysis had an increased risk of mortality compared to those who were on hemodialysis (aOR=6.474, 95% CI: 1.05-42.632, P=0.048). Conclusion: The study indicated that, 89 (73%) of patients had anemia, hyponatremia 43 (37%), and hyperkalemia 54 (47.8%) and also an older adult, predominantly male, constitute the majority of patients, with hypertension being common comorbidity. The study identified significant predictors of mortality, including sex, education level, length of hospital stay, and maintenance hemodialysis. Further prospective study is needed to assess survival rates and factors associated with survival among patients with renal dysfunction.