Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study

Autor: Keisha L. Gibson, Amy K. Mottl, Erica C. Bjornstad, Emily W. Gower, William Muronya, Yvonne M. Golightly, Stephen W. Marshall, Charles K. Munthali, Anthony G. Charles, Zachary H. Smith
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Malawi
medicine.medical_specialty
Epidemiology
030232 urology & nephrology
Comorbidity
Tertiary referral hospital
urologic and male genital diseases
lcsh:RC870-923
Trauma
Pediatrics
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
Hospital Mortality
Prospective Studies
Child
Prospective cohort study
Facial Injuries
Multiple Trauma
business.industry
urogenital system
Incidence
Torso
030208 emergency & critical care medicine
Pediatric Death
Length of Stay
medicine.disease
lcsh:Diseases of the genitourinary system. Urology
female genital diseases and pregnancy complications
3. Good health
Acute kidney injury
Socioeconomic Factors
Nephrology
Creatinine
Relative risk
Cohort
Africa
Wounds and Injuries
Female
Burns
business
Research Article
Kidney disease
Pediatric trauma
Zdroj: BMC Nephrology, Vol 21, Iss 1, Pp 1-12 (2020)
BMC Nephrology
ISSN: 1471-2369
DOI: 10.1186/s12882-020-01755-3
Popis: BackgroundAcute 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.MethodsProspective 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.ResultsWe 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.ConclusionsAKI 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.
Databáze: OpenAIRE
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