Introduction: 

The Saving Young Lives (SYL) project was initiated in2012 to address the burden of AKI in low resource settings where accessto life saving dialysis is suboptimal. However, between 2013-2015, only33% patients treated with peritoneal dialysis in eight such settingsrecovered, saving fewer lives than expected[1]. As part of SYL initia-tive, Kilonzo et al[2] dialyzed only 20 cases of AKI over a period of 2years. In this setting of availability of peritoneal dialysis, the numberdialyzed was strikingly low, highlighting the challenges in setting upthe program. Previous studies here in children have highlighted ahigher burden in neonates, suggesting the value of targeted approachguided by research. We aimed to systematically investigate, for thefirsttime in the country, the epidemiology and outcomes factors of AKI incritically ill adults. The current study looked at the occurrence of AKI,associated factors, short-term outcomes, and its influence on mortalityin patients admitted to critical units at a tertiary hospital in NorthernTanzania.

Methods:

this prospective cohort, baseline data was collected from320 consecutive patients admitted to ICUs. Serum creatinine and urineoutput were measured and KDIGO criteria was used to determine AKIstatus - the primary outcome was mortality at 28 days. Secondaryoutcomes were length of hospital stay and dialysis requirement.Associated factors were assessed using adjusted odds ratio and pre-dictors of mortality were identified. Kaplan Meier curves were built forsurvival analyses.

Results

The overall proportion of patients with AKI was very high,amounting to 55.3% of the entire cohort. The majority had AKI onadmission, mostly in KDIGO stage 2 or 3. Many patients were refferred

Conclusions: 

The burden of AKI is substantial. Patients presented inextremis; a large percentage with comorbidities, hemodynamic insta-bility and high UVA scores which was associated with AKI and highearlymortality. There is a need for strong and cheap predictive scoresto identify cases in a timely fashion. Targeting peritoneal dialysis inlarge centres without addressing gaps in knowledge, recognition, andearly referral from smaller centres may undermine the essential SYLprogram, hence a need to upgrade the approach to include differentlevels for interventions.