ACUTE KIDNEY INJURY IN AFRICA

1. ACUTE KIDNEY INJURY IN AFRICA BY ESTHER OBENG

2. Acute Kidney Injury (AKI) is the term used to describe the sudden loss of Kidney function.

3. The International Society of Nephrology’s (ISN) 0 by 25 initiative aims to prevent avoidable deaths from AKI by 2025, most of which occur in low and lower middle-income countries, including Africa.

4. AKI IN AFRICA • The pattern of AKI in Africa is vastly different from that of more developed countries. • The report from the Global Snapshot indicates that: • Patients with AKI in Africa were younger. • Community acquired AKI was common. • Dehydration was a common cause as were sepsis. • pregnancy- related AKI and animal envenomation

5. RISK FACTORS • In developed countries (resource sufficient regions) AKI primarily occurred in older patients, in the hospital setting and was associated with multi organ failure in patients with significant number of comorbidities.

6. RISK FACTORS • Lack of access to clean drinking water and sanitation, inadequate control of infection-carrying vectors, living in an area with geographical propensity for natural disasters (famine, flood, earthquake) and high incidence of tropical infections and/or venomous snake accidents are examples of environmental risk factors

7. RISK FACTORS • Living in a war zone increases the risk of trauma and infectious diseases and epidemics may increase the incidence of AKI. • In West Africa, burial practices and cemetery management affected the spread of Ebola virus disease. This cultural practice is an example of how cultural dimension can affect the overall risk of acute diseases and other complications (e.g. AKI) in the population.

8. Kidney Disease Related Death Rate *Per 100,000 http://www.worldlifeexpectancy.com/cause-of-death/kidney-disease/by-country/ accessed 2012 Oct.

10. Risk and burden of CKD ISN Global Kidney Health Atlas | 2017

11. Worldwide access to treatment for end-stage kidney disease: a systematic review Liyanage T, et al, Lancet 2015; 385: 1975–82

12. MAJOR CAUSES OF AKI BY REGION

13. AKI IN EGYPT

14. Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt Abd ElHafeez S, et al, Sci Rep, 2017; 7: 17163.

15. Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt Abd ElHafeez S, et al, Sci Rep, 2017; 7: 17163.

16. Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt Abd ElHafeez S, et al, Sci Rep, 2017; 7: 17163.

17. Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt Abd ElHafeez S, et al, Sci Rep, 2017; 7: 17163.

19. Clinical evaluation of acute kidney injury in Al-Zahraa University Hospital, Cairo, Egypt Ahmed LI, et al, The Egyptian Journal of Internal Medicine 2017, 29:16–23

21. Normal U/S

23. AKI IN GHANA

25. Demographics/Prevalence • Two hundred and six (206) cases of AKI were recorded over the period out of a total of 664 renal cases. There were 117 (56.8) males. Age range was from 1 day to 13 years (median 5yr 3mo). There were a total of 15, 371 paediatric admissions over the period, giving an AKI prevalence of 1.3%. But among all children with renal diseases admitted over the period, AKI was the commonest presentation (206 of 664 cases, [31%]).

26. Clinical Settings associated with AKI in children

28. AKI IN NIGERIA

30. AKI IN SOUTH AFRICA

32. Table 2. Pathological diagnoses of AKI (including biopsy proven cases).

33. “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Martin Luther King Jr.

34. THE WAY FORWARD • Increase the evidence about AKI • Improving awareness about AKI through advocacy • Developing interventions that will improve detection and care of AKI in low resource settings

35. THANK YOU