Over time, renal diseases have emerged as one of the world’s leading causes of morbidity and mortality. Chronic kidney disease (CKD) has recently been recognized as a public health concern. Chronic kidney disease mainly affects low-income countries, especially Sub-Saharan Africa, where it strikes young adults and hinders economic growth. Hospitals in developing countries lack advanced equipment, leading to misdiagnosis and worsening kidney disease, increasing death rates [Citation1].
The incidence of kidney diseases has been rising. The primary risk factors for kidney disease, which frequently leads to kidney failure, are diabetes mellitus and hypertension. This emphasizes the significance of primary prevention of diabetes and hypertension in addition to early detection and quick therapy of renal diseases in high-risk individuals [Citation2]. In Somalia, a country with a weak healthcare system and resources, scarcity of renal replacement therapy and renal biopsy, as well as limited accessibility to basic services, kidney diseases represent a serious threat to health. For individuals with kidney failure, hemodialysis is the only practical option, and its services are mainly found in large cities. Furthermore, Somalia has the lowest health and well-being indicators in the world and a high rate of morbidity and death overall [Citation3].
Due to the lack of a national registry system, the prevalence of renal disease in Somalia is still unknown, making it challenging to estimate the disease’s overall impact on the population as a whole [Citation4]. Since there is insufficient information on the causes of kidney disease, which is the precursor to kidney failure in Somalia, the aim of the study was to evaluate the pattern and outcome of renal diseases in hospitalized patients in a tertiary hospital in Mogadishu, Somalia.
We conducted a retrospective study at Mogadishu Somali Turkish Training and Research Hospital (MSTH) from January to December 2023. MSTH is a major teaching hospital in Somalia’s capital, receiving patients from Somalia and neighboring countries. 483 adults with renal disorders admitted to MSTH’s internal medicine unit were included. Patients with missing data were excluded. We examined how factors like age, health conditions, treatments, and tests influenced patient outcomes (recovery, death, CKD with/without dialysis). We collected patient data from medical records and analyzed it using Epi Info. Descriptive statistics summarized the data and chi-square tests assessed relationships between factors and patient outcomes (recovery, death, CKD). P-values less than 0.05 were considered significant. The study was approved by the Mogadishu Somali Turkey Training and Research Hospital’s IRB. Patient anonymity was ensured.
Older adults (≥60) had a higher prevalence of renal disease. There were more males 63.1% than females, with emergencies being the most common admission source 62.7%. CKD with dialysis 57.8% was the most frequent outcome. The recovery rate was 23%, and mortality was 7.9%. Most stays were less than a week, 62.7% ().
Table 1. Demographic characteristics and outcomes of patients with kidney diseases in tertiary hospital, Mogadishu, Somalia, 2023.
Nearly 40% had no comorbidities, but hypertension was most common at 26.3%. Over half, 57.1%, had abnormal ultrasounds suggestive of kidney damage. Chronic kidney disease 61.9% was the leading diagnosis, followed by acute injury 38.1%. Key lab findings included low calcium 64% and sodium 54.7%. Urine analysis showed protein 56.9% and blood 45.6% in many patients, with 26.1% having sugar. Almost half, 46.6%, had urinary tract infections, while viral hepatitis was less common (HBV+ 4.4%, HCV+ 1.2%). There are no statistically significant differences in the mean values of creatinine across the age groups ().
Table 2. Clinical and diagnostic features of patients with kidney diseases in tertiary hospital, Mogadishu Somalia, 2023.
The study examined factors like age, admission type, ultrasound results, and diagnosis in patients with kidney problems. They found that older age, emergency admissions, abnormal ultrasounds, and needing dialysis were linked to worse outcomes (chronic kidney disease with dialysis) (). On the other hand, being female and having normal ultrasounds were linked to a better chance of full recovery (p-values ≤0.05). Chronic kidney disease was most common, followed by acute injury, similar to findings in a Ghanaian study [Citation1]. In contrast, in many studies [Citation5], glomerular diseases were their common finding. Although there is a difference between the target population in our study and theirs, the fact is that many developing countries, particularly in Africa, are sorely lacking renal biopsy in the practice of nephrology, which is a cornerstone in diagnosing, prognosticating and guiding the treatment of many renal diseases, especially glomerular diseases [Citation6]. In accordance with a previous study, the majority [Citation7] of our study participants were male, while most of our participants aged more than or equal to 60 years; in contrast to the study, Aslam et al. revealed that the majority of their participants were between 41 and 50 years old. The difference might be the lifestyle variation, as most Somali people present as the last stage of the disease. In our study, a large portion of participants required renal dialysis, which was similar to the findings of Sylvanus et al. in Tanzania (42%) [Citation8]. This highlights the fact that dialysis is expensive; however, it is the only option available in Somalia.
Table 3. Association between factors and outcome of patients with kidney diseases at tertiary hospital, Mogadishu, Somalia, 2023.
This hospital-based study provides valuable data on under-reported kidney disease in Somalia, revealing common causes and outcomes. However, focusing on a single hospital limits generalizability. Ideally, data from multiple centers would give a more complete picture.
In conclusion, chronic kidney disease was most common, often progressing to dialysis. Strengthening healthcare, promoting education, and ensuring equal dialysis access are crucial to improving patient care. Early diagnosis and treatment can prevent advanced kidney disease.
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References
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