Department of Paediatrics

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Browsing Department of Paediatrics by Subject "acute kidney injury"

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    Open Access
    Acute Kidney Injury in Children with Severe Malaria Is Common and Associated with Adverse Hospital Outcomes
    (Oxford University Press, 2019) Oshomah-Bello, E.; Esezobor, C.I.; Solarin, A.U.; Njokanma, F.
    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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    Open Access
    Clinical profile and hospital outcome of children with severe acute kidney injury in a developing country
    (Oxford University Press, 2015) Esezobor, C.I.; Ladapo, T.A.; Lesi, F.E.
    Introduction: In resource-constraint regions of the world, the spectrum of childhood diseases is changing, creating a need to clearly define the epidemiology of severe acute kidney injury (AKI). Methods: Medical records of children aged between 1 month and 17 years with stage 3 AKI in a tertiary hospital were reviewed. Results: Ninety-one children, comprising 63 (69.2%) males and 26 (28.6%) infants, were studied. Majority (75.8%) had stage 3 AKI at the point of hospitalization. Sepsis (41.8%), primary kidney diseases (PKD; 29.7%) and malaria (13.2%) were the most common causes of stage 3 AKI. Twenty-eight (30.8%) children died. Mortality was highest in those with sepsis, less than 5 years old and needing dialysis. Conclusion: Sepsis, PKD and malaria were the most common causes of severe AKI. A third of children with severe AKI died. Mortality was highest in those less than 5 years old, with sepsis and needing dialysis.