Spectrum of renal disease among patients admitted in internal medicine department in Cairo University Hospitals

Abstract Background Renal diseases are a major contributor to global morbidity and mortality. However, data describing their clinical spectrum and outcomes in Egypt remain limited. This study aimed to evaluate the burden, management, and outcomes of renal diseases among acutely admitted patients in a tertiary care setting. Methods A prospective observational clinical audit was conducted over six months (February–July 2024) in the internal medicine department at Cairo University Hospitals. All adult patients admitted through the emergency department were included. Patients were categorized into renal and non-renal groups. Data collected included demographics, comorbidities, laboratory and imaging findings, interventions, hospital stay, and outcomes. Statistical analysis included chi-square, t-tests, and multivariable logistic regression to identify predictors of mortality. Results A total of 202 patients were included (median age 54 years), with 52% classified as renal cases. Hypertension (55.9%), diabetes (37.1%), and pre-existing chronic kidney disease (22.8%) were highly prevalent. Among renal patients, acute kidney injury (AKI) was the leading cause of admission (37.1%). Hemodialysis was required in 40.9% of cases. Renal patients had longer hospital stays (mean 9.9 days) and significantly higher costs (median 895–5980 L.E.). Outcomes were less favorable: 37.1% improved, 27.6% progressed to CKD, 26.7% to end-stage renal disease (ESRD), and 8.6% required ICU admission. Mortality was 13.3%. Non-renal patients had better outcomes, with 91.8% improvement and lower resource utilization. Overall mortality was 11.4%. Advanced age and low serum bicarbonate were independent predictors of mortality. Conclusion Renal diseases constitute a substantial clinical and economic burden in hospitalized patients. Early detection, risk stratification, and optimized management strategies are essential to improve outcomes and reduce healthcare costs.