Acute Renal failure as seen at Kenyatta National Hospital between January 1984 And December 1985

Abstract

47 patients with acute renal failure without a background of chronic renal failure were studied between January 1984 to December 1985. The aim was to study several aspects of the presentation and management of Acute Renal Failure at Kenyatta National Hospital. The mean age of presentation was 27.8 years and

the peak age was between 21 and 40 years. The morta­ lity rate was 40.4%. There were 21 males and 26 females. Most patients carne from Nairobi and the surrounding areas within easy reach of Kenyatta

National Hospital. There were

distant areas.

few patients from

The mean duration of stay in hospital was 20.1

days. The mean period from the start of the disease to the onset of oliguria was 2.8 days, and the mean period of oliguria was 13.4 days. The mean period of diuresis was 14.4 days. Most patients (46.8%) had medically orientated

problems but obstetrical and gynaecological problems had a high"mortality. Cornmon medical causes of acute renal failure were acute glomerulonephritis and malaria, while obstetric hemorrhage due to various causes was the most cornmon cause in obstetrics. Surgical patients were very few.

iv

Complications that were associated with a high mortality were neuropsychiatric, and infections. Bleeding diathesis, pulmonary edema and anemia were also associated with increased mortality. Pericard~ tis was a rare complication, as was pulmonary embolism. Hyperkalemia was associated with a high mortality, but a high blood urea nitrogen was associated with a prolonged stay in the ward. There was a high incidence of anemia. Dialysis was generally started when the levels of potassium and blood urea nitrogen were high but was associated with good prognosis.