DOI: 10.4103/ajoim.ajoim_7_25 ISSN: 2278-8239

Clinical Profile and Outcome of In-Hospital Patients with Obstructive Nephropathy Admitted for Hemodialysis in Two Nigerian Urban Tertiary Care Centers

Titilope Adetoun Bamikefa, Imuetinyan Rashida Edeki, Peter K. Uduagbamen, Olufemi O. Ojewuyi, Abiodun Ojewuyi, Afolabi Olugboyega
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bstract

Background:

Obstructive nephropathy (ON) contributes significantly to the global cache of chronic kidney disease (CKD) patients reliant on hemodialytic therapy. The study was designed to elucidate the clinico-anthropologic correlates, outcomes, and survival determinants of in-hospital patients with ON admitted for hemodialysis in two Nigerian urban tertiary care centers.

Materials and Methods:

A two-centered retrospective evaluation of the clinical and dialysis documentations of eighty-one (81) patients with ON who had dialysis between September 1, 2021, and August 31, 2023, was undertaken. Descriptive and multivariate analyses on the clinico-anthropologic correlates and biochemical data obtained from these patients were undertaken using statistical product and service solutions version 25. Kaplan Meier survival plots were drawn with P value set at <0.05.

Results:

Of the 81 patients aged between 21 and 90 years with ON, who were offered 937 sessions of dialysis cumulatively, 56 (69.0%) were males. The mean age was 61.7 ± 15.5 years. Malignant causes (n = 48, 59.3%) predominated, with prostatic cancer responsible for 40% of all cases of ON. Co-morbid conditions were identified in 43.2% (n = 35). Twice-weekly hemodialysis sessions comprised the majority (n = 44, 53.4%). The mortality rate was 11.6%. Acute renal deterioration heralded by sepsis on background CKD was predominant, occurring in 56 (71.6%) of these patients. Pre-dialytic sodium level (P = 0.012) and duration on dialysis (P = 0.027) were predictive of the outcomes. The survival of patients with ON was statistically influenced by intradialytic hypotension on Kaplan Meier analysis.

Conclusion:

Formulating preventive policies targeting diverse etiological bedrock of ON should be a global goal to reduce its rising burden as a cause of end-stage renal disease.

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