The prevalence of acute kidney injury among children with severe malaria in a tertiary hospital in South-West Nigeria

Abstract

Background: Acute kidney injury (AKI) is a dire complication of severe malaria with a high mortality rate. AKI worsens the prognosis of children with malaria. Despite the poor prognostic index, there is scarce data on the prevalence of AKI in severe malaria in Nigeria. Therefore, this study aimed to document the prevalence of AKI in severe malaria among children in a tertiary hospital in South-West Nigeria. Methods: This was a cross-sectional study. Children with WHO-defined severe malaria were recruited, and AKI was defined using the KDIGO and WHO criteria. The serum creatinine was measured, and the data were analysed, with a p<0.05 considered significant. Results: A total of 126 children aged 1-15 years, comprising 70 (55.6%) males with a male-to-female ratio of 1.25:1, were studied. The prevalence of AKI was 23.8% using KDIGO and 11.9% using WHO criteria, with a statistically significant difference (p=0.001). The majority (50%) were in stage 1 AKI, while 36.7% were in stage 3. The haemoglobin concentration was statistically significantly associated with the occurrence of AKI. Conclusions: The prevalence of AKI using KDIGO doubles that of the WHO criteria in the presence of severe malaria. There is a need to review the criteria for AKI diagnosis in severe malaria.