Intensive Care Unit Dialysis Practice, Clinical Outcomes, and Associate Factors Among Critically Ill Patients at St.Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia: A Prospective Cohort Study Design

Introduction : Acute kidney injury (AKI) is a common complication in critically ill patients, associated with increased morbidity and mortality. Despite its widespread use, there is limited research examining intensive care unit dialysis practice and clinical outcomes among critically ill patients. Objective : The aim of this study was to investigate intensive care unit dialysis practice, clinical outcomes, and associate factors among critically ill patients at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia 2024 Methods and Materials : Hospital based prospective quantitative cohort study was conducted in St. Paul Hospital Millennium Medical College over a period of seven month from December 1, 2023 - June 30, 2024. The study used a data abstraction checklist to collect data from patients' charts, which was processed using Kobo collect software and exported for further analyzed using SPSS version 25. Descriptive analysis was performed to describe study variables, and binary and multivariable logistic regression was used to identify significant factors at PV < 0.05, with a 95% CI for the final model. The clinical trial number is not applicable. Result A study involving 301 AKI patients admitted to the ICU, with 90% response rate, with a mean age of 34.3 ± 15.4 Years old. Females were the most frequently admitted patient 49 (54.4%). The study found that most patients with acute kidney injury (AKI) achieved good renal recovery, with 67.8% successfully weaned from ICU care and transferred to a general ward. Sepsis 46 (51.1%) and advanced age > 60 years old (10.0%) were the leading risk factors. This study identified factors significantly associated with patient outcomes were: patient who had Urea Reduction Ratio below 55–60% range were 6 times more likely to have increased mortality than a patient who has Urea Reduction Ratio of greater than 60% (OR = 6.04, 95% CI 1.09-33.318) and Patients with a higher APACHE II score were 2.7 times more likely to experience worsened ICU outcomes compared to those with lower score [AOR] = 2.7, 95% CI 1.086–17.879). Conclusion : The study revealed that 67.8% of acute kidney injury (AKI) patients successfully recovered from ICU care. This study found that sepsis was the most common cause of acute kidney injury (AKI) leading to dialysis in the study setting Intensive care unit. The severity of illness, as measured by the APACHE II score, was a strong predictor of mortality. Inadequate dialysis, characterized by a low urea reduction ratio, was also associated with increased mortality.