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. 2021 Feb:103:124-131.
doi: 10.1016/j.ijid.2020.11.006. Epub 2020 Nov 8.

Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis

Adewale E Adetunji  1 , Magdalene Ayenale  1 , Irene Akhigbe  1 , Lilian O Akerele  1 , Efosa Isibor  1 , Juliet Idialu  1 , Florence O Aideloje  2 , Ekene Emuebonam  3 , Chris Aire  3 , Donatus I Adomeh  3 , Ikponmwosa Odia  3 , Rebecca O Atafo  4 , Martha O Okonofua  4 , Adaugo Owobu  1 , Ephraim Ogbaini-Emovon  3 , Ekaete A Tobin  3 , Danny A Asogun  3 , Sylvanus A Okogbenin  5 , Pardis Sabeti  6 , Christian T Happi  7 , Stephan Günther  8 , Chukwuemeka O Azubuike  9 , Mojeed Rafiu  9 , Angela Odike  1 , Sylvia C Olomu  1 , Michael O Ibadin  1 , Peter O Okokhere  9 , George O Akpede Prof  10
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Free article

Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis

Adewale E Adetunji et al. Int J Infect Dis. 2021 Feb.
Free article

Abstract

Objectives: To assess the prevalence of acute kidney injury (AKI), and its impact on outcome in hospitalized pediatric patients with Lassa fever (LF).

Methods: We reviewed the presenting clinical and laboratory features and outcomes of 40 successive hospitalized children with PCR-confirmed LF. The diagnosis and staging of AKI was based on KDIGO criteria. We compared groups of patients using t- or χ2 tests as necessary, and took p-values <0.05 as indicative of the presence of significant differences.

Results: Sixteen (40%) children had AKI. Case fatality rate (CFR) was 9/16 (56%) in children with and 1/24 (4%) in those without AKI (OR [95% CI] of CFR associated with AKI = 29.57 [3.17, 275.7]). Presentation with abnormal bleeding (p = 0.008), encephalopathy (p = 0.004), hematuria plus proteinuria (p = 0.013), and elevated serum transaminase levels (p <0.02) were significantly associated with an increased prevalence of AKI.

Conclusion: AKI prevalence in hospitalized pediatric patients with Lassa fever is high, and correlated with illness severity/CFR. The high prevalence underscores the need for access to hemodialysis, and clinical presentation and/or presence of hematuria plus proteinuria could serve as a ready prompt for referral for such specialized care.

Keywords: Acute kidney injury; Biomarkers of illness severity; Dipstick urinalysis; Outcome; Pediatric Lassa fever; Prevalence; Risk factors.

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