Severe acute kidney injury among children in a tertiary health facility in North-Western Nigeria: Clinical profile and outcome
Keywords:
Severe acute kidney injury, Children, Sokoto, Profile, Mortality factorsAbstract
Objectives: To determine the profile of children with severe acute kidney injury (AKI) at the point of admission into Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, the demographic factors associated with AKI severity, the outcome of cases, and factors associated with hospital mortality.
Methods: A 2- year prospective cross-sectional survey of children aged one month to 14 years admitted into Emergency Paediatric Unit (EPU) of UDUTH Sokoto with the diagnosis of severe (stage 3) AKI as defined by Kidney disease improving global outcome (KDIGO).
Results: Forty- four (1.4%) of the 3,050 children had severe AKI. They were 29(65.9%) males and 15(34.1%) females. Mean age at presentation was 3.61±2.1 years. Twenty- seven (61.4%) were from a low socio-economic family status and both parents had no formal education in 33 (75.0%) of the cases. Majority 33(75.0%) of them presented late (more than 72 hours of onset of illness) to EPU. The commonest features were fever 34(77.3%), and oliguria or anuria 33(75.0%). The commonest abnormal electrolytes were metabolic acidosis 42(95.5%), and Hyponatraemia 28(63.6%). Sepsis was the commonest 13(29.5%) cause of severe AKI. Twenty seven (61.4%) were discharged, 15(34.1%) died, 2(4.5%) left against medical advice. Mortality was associated with late presentation, diagnosis of sepsis, fluid overload, bleeding diasthesis, severe hyperkalaemia, and requirement for dialysis.
Conclusion: The commonest cause of severe AKI was sepsis and mortality from severe AKI was high.
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