Risks and recognition of acute kidney injury in children: a local snapshot of an Academic Hospital complex in central South Africa
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Date
2018
Authors
Coetzee, P. F.
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
i. Introduction and aim:
Acute kidney injury (AKI) plays a major role in poor patient outcomes and
is associated with increased morbidity and mortality. Epidemiological data
of children with AKI in low-resource settings are poorly described in the
literature. This study aimed to assess the AKI incidence, risks and
recognition in hospitalised children in Bloemfontein.
ii. Methods:
We conducted an observational prospective cross-sectional study of all
children admitted to the Bloemfontein Academic Hospital Complex on a
chosen "index day". All patients aged 1 month to 13 years admitted to the
Bloemfontein Academic Hospital Complex on the "index day" were
screened for eligibility for entry into the study. We used the Kidney
Disease: Improving Global Outcomes (KDIGO) criteria to define acute
kidney injury. The identified AKI cases were followed up one week later
to determine outcome.
iii. Results:
A total of 128 patients were screened and 58 patients were enrolled on the
"index day". The researcher identified acute kidney injury in 14 of the 58
enrolled patients, of which the primary clinical team only identified three.
Anaemia (p=0.005, OR 7.8, 95% CI 1.5-39.9) was recognised as the most
significant inherent risk factor for the development of acute kidney injury.
Sepsis (p=0.003, OR 7.5, 95% CI 1.7-38.1) and circulatory shock
(p=0.002, OR 23.9, 95% CI 2.1-1154.7) were the most prominent
aetiologies.
iv. Conclusion:
Acute kidney injury is common and largely unrecognised despite risk
factors in our setting. We identified aetiological factors common to larger,
multi centre studies. Additional strategies are needed to raise awareness of
acute kidney injury in central South Africa.
Description
Keywords
Kidney injury, Aetiologies, Kidney injury -- Diagnosis, Acute kidney injury (AKI), Dissertation (M.Sc. (Paediatrics and Child Health))--University of the Free State, 2018