Renal Insufficiency in Cancer Patients and Associated Demographic, Clinical and Treatment Characteristics at Kenyatta National Hospital, Nairobi, Kenya

Renal insufficiency is sub-optimal kidney function, affecting approximately 10% of the world population. In sub-Saharan Africa, it is approximated at 14% of the population whereas the kidney disease burden in Kenya is estimated to be at 4%. Studies show that at least 27.1% of cancer patients are suffering from renal insufficiency and need some chemotherapeutic drug adjustment. The objective of this study was to establish the prevalence of renal insufficiency and the associated clinical, demographic and treatment factors among cancer patients at KNH. A cross-sectional study where data was collected using a structured interviewer-administered questionnaire and hospital records. Systematic random sampling without replacement was used to select eligible 330 participants (patients) from Oncology wards and clinics at KNH. The information from the questionnaires was entered into a computer, cleaned, coded and loaded into R version 4.1.2 statistical software for analysis. Calculation of estimated GFR was done by CKD-Epi in micromole/l using a medical calculator to diagnose renal insufficiency and classify accordingly. The data was analyzed using both descriptive and bivariate/ multivariate regression analysis. All p-values were two-sided and the results were considered statistically significant at p < 0.05. A total of 56.1% were females and others were male. Of the 330 study participants, 42.7% were aged between 41-60, 41.5% above 60 years and the rest below 41 years. The prevalence of renal insufficiency was 38% (95% CI 33, 44%). Age above 60 years and the use of taxanes were significantly associated with renal insufficiency before and after adjustment (p-values <0.05). In conclusion, the prevalence of renal insufficiency among patients with cancer was high in this study of which the majority had stage 2 renal failures. Patients aged above 60 years had significantly higher odds of renal insufficiency while patients on taxanes had significantly lower odds of renal insufficiency