Renal function of hospitalised adult patients with trauma at Mulago national referral hospital
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Globally trauma is the leading cause of death in persons aged 5 to 44 years and accounts for approximately 10% of all deaths in general. In Uganda more than 25% of all deaths recorded in urban areas are due to trauma. Tissue injury often caused by massive uncontrolled bleeding may lead to tissue ischemia and contribute to life threatening multiple organ failure. Acute kidney injury is a serious complication following trauma, however data on renal function following major trauma is limited. The study was therefore done to assess renal function among hospitalized patients with trauma in Mulago National Referral Hospital to find out patients’ renal function. Methods: This was a cross sectional study conducted at Mulago National Referral Hospital between May 2017 and July 2017. The study recruited 303 participants with trauma whose data was collected using a pretested questionnaire. Renal function was assessed by measuring serum creatinine levels and electrolyte levels particularly sodium, chloride and potassium that were then compared with the normal physiological levels. Data was entered into Epi data then exported to SPSS version 22 for analysis. Ethical approval was obtained from the Ethics Review Board and informed consent was obtained from all study participants. Results: Three hundred and three participants were recruited. There were 271 (89.4%) males and 32 (10.6%) females with a mean age of 28 years (IQR 23,35). Majority of the participants 255/303(84.2%) had normal serum creatinine levels while 48/303(15.8%) had high creatinine levels, indicating renal dysfunction. Of the 303 participants 216(71.3%) of the participants had electrolyte levels within normal range. Compared with the participants who had normal creatinine, 42/48 (87.5%); the participants that had high creatinine level had not received any prior intravenous fluid resuscitation (P=0.028, OR=0.37, 95% CI 0.15-0.92). Majority of participants with renal dysfunction 35/48 (72.9%) had head injury (P = 0.003) with low GCS (<14) p = 0.001. Conclusion: There is high prevalence of elevated serum creatinine among patients admitted with trauma at Mulago especially among those with head injury and those that have not received prior intravenous fluid resuscitation. Therefore, clinicians should be on the lookout for these patients in order to improve renal function and prevent worsening of their renal impairment.