Trends, causes and outcomes of Acute Kidney Injury (AKI) among children attending University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu

Abstract

Background: Acute Kidney Injury (AKI) in children is increasingly being recognized as a major problem in resource poor countries like Nigeria. In our own setting where resources for renal replacement therapy are limited, it becomes expedient to identify the cases early, ascertain the common causes and challenges in management. This will inform early interventions and strategies for prevention. Objectives: This study sought to describe the trends,causes and outcomes in the management of AKI among children attending pediatric nephrology unit of the University of Nigeria Teaching Hospital. Methods: A retrospective cross- sectional study whereby case folder of children with discharge diagnosis of AKI seen in the pediatric nephrology unit of the University of Nigeria Teaching Hospital in Southeast Nigeria. Results: 51 case folders fulfilled the inclusion criteria. The age range was 0.8-16 with a mean of 5.3±4.6. There was male predominance with M:F ratio of 2.2:1.The commonest presenting feature was fever (78.4%). Majority (82.9%) came in with greater than and equal to stage 2 AKI (KDIGO) , with mean creatinine value of 494.6±367.44 μmmol. Sepsis and malaria were common associated diagnoses. Eight patients (11.8%) were dialyzed and mortality was 3.9%. Conclusion: Febrile illnesses such as malaria and sepsis are the commonest cause of AKI in this study and this occurs between the ages of 1 and 9 years. Few of these children with AKI benefited form dialysis. Mortality is low and outcome in this study seems good Keywords: Children; AKI; renal replacement therapy; prevention.