Outcomes of acute kidney injury in children and adults in Sub-Saharan Africa

2016 ◽  
Vol 1 ◽  
pp. 40-40
Author(s):  
Jorge Cerdá ◽  
Dwomoa Adu ◽  
Norbert H. Lameire
2016 ◽  
Vol 4 (4) ◽  
pp. e242-e250 ◽  
Author(s):  
Wasiu A Olowu ◽  
Abdou Niang ◽  
Charlotte Osafo ◽  
Gloria Ashuntantang ◽  
Fatiu A Arogundade ◽  
...  

2018 ◽  
Vol 12 (4) ◽  
pp. 521-526 ◽  
Author(s):  
Adebowale D Ademola ◽  
Adanze O Asinobi ◽  
Esther Ekpe-Adewuyi ◽  
Adejumoke I Ayede ◽  
Samuel O Ajayi ◽  
...  

Abstract Background Epidemiological data on paediatric acute kidney injury (AKI) in sub-Saharan Africa are limited and largely retrospective. We performed a prospective study of AKI among patients admitted through the emergency room. Methods Children admitted to the post-neonatal emergency room of the University College Hospital, Ibadan, Nigeria between February 2016 and January 2017 were studied. AKI was defined by Kidney Disease: Improving Global Outcomes serum creatinine criteria. AKI ascertainment relied on serum creatinine measurements carried out in routine care by post-admission Day 1. We compared in-hospital mortality by post-admission Day 7 for patients with and without AKI (no-AKI). Results Of the 1344 children admitted to the emergency room, 331 were included in the study. AKI occurred in 112 patients (33.8%) with a median age of 3.1 years [interquartile range (IQR) 0.9–9.4] and was Stage 3 in 50.5% of the cases. The no-AKI group had a median age of 1.8 (IQR 0.7–5.8) years. The underlying diagnoses in patients with AKI were sepsis (33.0%), malaria (12.5%) and primary renal disorders (13.4%). Twenty-four of the patients with AKI underwent dialysis: haemodialysis in 20 and peritoneal dialysis in 4. By Day 7 of admission, 7 of 98 (7.1%) patients in the AKI group had died compared with 5 of 175 (2.9%) patients in the no-AKI group [odds ratio 2.6 (95% confidence interval 0.8–8.5)]. Outcome data were not available for 58 (17.5%) patients. Conclusions AKI is common among paediatric emergency room admissions in a tertiary care hospital in sub-Saharan Africa. It is associated with high mortality risk that may be worse in settings without dialysis.


2012 ◽  
Vol 81 (4) ◽  
pp. 331-333 ◽  
Author(s):  
John G. Callegari ◽  
Kajiru G. Kilonzo ◽  
Karen E. Yeates ◽  
Garry J. Handelman ◽  
Fredric O. Finkelstein ◽  
...  

2013 ◽  
Vol 36 (3-4) ◽  
pp. 226-230 ◽  
Author(s):  
John Callegari ◽  
Sampson Antwi ◽  
Grzegorz Wystrychowski ◽  
Ewa Zukowska-Szczechowska ◽  
Nathan W. Levin ◽  
...  

2019 ◽  
Vol 66 (2) ◽  
pp. 218-225
Author(s):  
Eunice O Oshomah-Bello ◽  
Christopher I Esezobor ◽  
Adaobi U Solarin ◽  
Fidelis O Njokanma

Abstract Background The prevalence of acute kidney injury (AKI) in children with severe malaria in sub-Saharan African may have been underestimated. The study aimed to determine the prevalence of AKI in children with severe malaria and its association with adverse hospital outcomes. Methods At presentation, we measured complete blood count, serum bilirubin, and serum electrolytes, urea and creatinine in children with severe malaria. At 24 h after hospitalization, we repeated serum creatinine measurement. Urine passed in the first 24 h of hospitalization was also measured. We defined AKI and its severity using the Kidney Disease: Improving Global Outcome AKI guidelines. Results The study involved 244 children (53.3% males) with a median age of 3.5 (1.9–7.0) years. One hundred and forty-four (59%) children had AKI, and it reached maximum Stages 1, 2 and 3 in 56 (23%), 45 (18.4%) and 43 (17.6%) children, respectively. The majority (86.1%) with AKI had only elevated serum creatinine. Mortality increased with increasing severity of AKI on univariate analysis but weakened on multiple logistic regression. Mortality was also higher in those with both oliguria and elevated serum creatinine than in those with elevated serum creatinine only (50% vs. 4.8%, p < 0.001). Furthermore, children with AKI spent three days more in hospital than those without AKI (p < 0.001). Conclusions Acute kidney injury complicates severe malaria in 6 out of every 10 children and is commonly identified using elevated serum creatinine. It is also associated with adverse hospital outcome.


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