title: Renal impairment among acute hospital admissions in a rural Ethiopian hospital.
abstract: OBJECTIVE
  Acute renal injury (AKI) is a relatively common clinical condition, reported to be associated with high rates of in-hospital mortality. Although here is an 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, which is addressed directly in this study.
  
  
  METHODS
  We describe the prevalence, clinical characteristics and impact of AKI in patients admitted to a single centre in Ethiopia with no dedicated renal services.
  
  
  RESULTS
  Renal function tests are not preformed routinely in many Ethiopian hospitals. This occurred in 32% of all patients in this study, falling to 23% on surgical wards. As a consequence no cases of AKI were identified in the context of surgical admissions. AKI was only identified in a cohort of patients on medical wards, with a prevalence of roughly 20% of medical patients in which renal function was measured. The patients with AKI were younger than those at risk of AKI in studies from the developed World but were older than those who did not develop AKI in this study. In the majority of cases AKI could be considered to be pre-renal in its origin. In contrast to studies in the developed World, AKI did not adversely impact on either duration of hospital stay or on patient mortality. Residual renal impairment was, however, common at the point of discharge.
  
  
  CONCLUSIONS
  The data suggest subtle differences in the nature and impact of AKI between those published and mainly derived from the developed world and patients in sub-Saharan Africa.
authors.affiliation: Institute of Nephrology, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Riley
authors.forename: Ermias
authors.initials: E
authors.lastname: Diro
authors.forename: Peter
authors.initials: P
authors.lastname: Batchelor
authors.forename: Alula
authors.initials: A
authors.lastname: Abebe
authors.forename: Ashenafi
authors.initials: A
authors.lastname: Amsalu
authors.forename: Yewondwossen
authors.initials: Y
authors.lastname: Tadesse
authors.forename: John
authors.initials: J
authors.lastname: Williams
authors.forename: Aled O
authors.initials: AO
authors.lastname: Phillips
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D003906:Developing Countries / Q000706:statistics & numerical data; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult