Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study
Abstract Background Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa. Methods...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-020-01755-3 |
| _version_ | 1811286549638152192 |
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| author | Erica C. Bjornstad William Muronya Zachary H. Smith Keisha Gibson Amy K. Mottl Anthony Charles Stephen W. Marshall Yvonne M. Golightly Charles K. Munthali Emily W. Gower |
| author_facet | Erica C. Bjornstad William Muronya Zachary H. Smith Keisha Gibson Amy K. Mottl Anthony Charles Stephen W. Marshall Yvonne M. Golightly Charles K. Munthali Emily W. Gower |
| author_sort | Erica C. Bjornstad |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa. Methods Prospective cohort study of pediatric trauma patients admitted to a tertiary referral hospital in Malawi. Participants enrolled at admission were followed prospectively throughout their hospitalization. AKI was defined by creatinine-only Kidney Disease Improving Global Outcomes criteria. We calculated descriptive statistics and univariate relative risks (RR) for hypothesis-generation of potential risk factors associated with AKI. Results We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4 to 10%. The new Schwartz equation estimated baseline creatinine values best and yielded an AKI incidence of 9.7%. Almost one in ten children died during hospitalization, but those with AKI (n = 4) were at significantly higher risk of death compared to those without AKI (40.0% vs 6.2%; RR 6.5, 95% CI 2.2–19.1). Burn injuries were most commonly associated with AKI (63.6%). Other potential AKI risk factors included multiple injuries, trunk or facial injuries, and recent consumption of herbal remedies. Conclusions AKI occurs in up to 10% of admitted pediatric trauma patients in Malawi and increases the risk of death 7-fold compared to those without AKI. This large unrecognized burden in trauma requires further investment by researchers, clinicians and policymakers to develop evidenced-based triage, recognition, and management approaches to prevent the associated sequelae and potential mortality from AKI. |
| first_indexed | 2024-04-13T03:02:13Z |
| format | Article |
| id | doaj.art-28d1cfe099854433a989309e839229c4 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-13T03:02:13Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-28d1cfe099854433a989309e839229c42022-12-22T03:05:23ZengBMCBMC Nephrology1471-23692020-03-0121111210.1186/s12882-020-01755-3Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational studyErica C. Bjornstad0William Muronya1Zachary H. Smith2Keisha Gibson3Amy K. Mottl4Anthony Charles5Stephen W. Marshall6Yvonne M. Golightly7Charles K. Munthali8Emily W. Gower9Department of Pediatrics, Division of Nephrology, University of Alabama BirminghamDepartment of Surgery, Kamuzu Central HospitalUniveristy of North Carolina Project MalawiDepartment of Medicine, Division of Nephrology and Hypertension, University of North CarolinaDepartment of Medicine, Division of Nephrology and Hypertension, University of North CarolinaDepartment of Surgery, University of North CarolinaDepartment of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Public HealthDepartment of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Public HealthDepartment of Medicine, Renal Unit, Kamuzu Central HospitalDepartment of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Public HealthAbstract Background Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa. Methods Prospective cohort study of pediatric trauma patients admitted to a tertiary referral hospital in Malawi. Participants enrolled at admission were followed prospectively throughout their hospitalization. AKI was defined by creatinine-only Kidney Disease Improving Global Outcomes criteria. We calculated descriptive statistics and univariate relative risks (RR) for hypothesis-generation of potential risk factors associated with AKI. Results We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4 to 10%. The new Schwartz equation estimated baseline creatinine values best and yielded an AKI incidence of 9.7%. Almost one in ten children died during hospitalization, but those with AKI (n = 4) were at significantly higher risk of death compared to those without AKI (40.0% vs 6.2%; RR 6.5, 95% CI 2.2–19.1). Burn injuries were most commonly associated with AKI (63.6%). Other potential AKI risk factors included multiple injuries, trunk or facial injuries, and recent consumption of herbal remedies. Conclusions AKI occurs in up to 10% of admitted pediatric trauma patients in Malawi and increases the risk of death 7-fold compared to those without AKI. This large unrecognized burden in trauma requires further investment by researchers, clinicians and policymakers to develop evidenced-based triage, recognition, and management approaches to prevent the associated sequelae and potential mortality from AKI.http://link.springer.com/article/10.1186/s12882-020-01755-3Acute kidney injuryTraumaAfricaPediatricsEpidemiology |
| spellingShingle | Erica C. Bjornstad William Muronya Zachary H. Smith Keisha Gibson Amy K. Mottl Anthony Charles Stephen W. Marshall Yvonne M. Golightly Charles K. Munthali Emily W. Gower Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study BMC Nephrology Acute kidney injury Trauma Africa Pediatrics Epidemiology |
| title | Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study |
| title_full | Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study |
| title_fullStr | Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study |
| title_full_unstemmed | Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study |
| title_short | Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study |
| title_sort | incidence and epidemiology of acute kidney injury in a pediatric malawian trauma cohort a prospective observational study |
| topic | Acute kidney injury Trauma Africa Pediatrics Epidemiology |
| url | http://link.springer.com/article/10.1186/s12882-020-01755-3 |
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