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Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

El-hussein E A El-hassan, Mohamed B Ghalib, Azam I S Ibrahim, Bethan Phillips, Aled Owain Phillips

Abstract


Background. Acute kidney injury (AKI) is a relatively common clinical condition, associated with high rates of mortality. Although there is extensive literature on the nature and consequence of AKI in the developed world, much less is known in the developing world and more specifically in sub-Saharan Africa (SSA).

Objectives. To describe the demographics, histological diagnosis and clinical course of patients presenting with AKI to a single centre in Sudan.

Methods. Retrospective data were collected on 100 consecutive patients with AKI and an active urinary sediment, who underwent diagnostic native percutaneous renal biopsy.

Results. The mean (standard deviation) age of those biopsied was 33.6 (14.1) years of age, with a preponderance (58%) of females. The most common clinical indications for biopsy were AKI associated with haematuria and proteinuria (72%), AKI and proteinuria (22.5%) or AKI and haematuria (5%). The frequencies of the most common primary glomerulonephritides (GN) were focal segmental GN (15%) and mesangiocapillary GN (8%). Lupus nephritis was the most frequent secondary GN associated with AKI (31%) and the most common overall histological diagnosis. Peak creatinine, but not oliguria, at presentation predicted likelihood of remaining dialysis-dependent. Age at presentation but not baseline renal function by estimated glomerular filtration rate (eGFR), was associated with the likelihood of having residual chronic kidney disease following an episode of AKI.

Conclusions. The data suggested differences in the pattern of intrinsic renal/glomerular disease leading to AKI to those published and mainly derived from the developed world and patients in SSA.


Authors' affiliations

El-hussein E A El-hassan, Nephrology Unit, Armed Forces Teaching Hospital Omdurman, Sudan

Mohamed B Ghalib, Faculty of Medicine, Karary University, Omdurman, Sudan

Azam I S Ibrahim, Nephrology Unit, Armed Forces Teaching Hospital Omdurman, Sudan

Bethan Phillips, Institute of Nephrology, Cardiff University School of Medicine, Cardiff, Wales, UK

Aled Owain Phillips, Institute of Nephrology, Cardiff University School of Medicine, Cardiff, Wales, UK

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Keywords

AKI; Acute kidney injury; Epidemiology; Demographics

Cite this article

South African Medical Journal 2016;106(7):704-708. DOI:10.7196/SAMJ.2016.v106i7.10392

Article History

Date submitted: 2015-11-26
Date published: 2016-06-17

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