1
|
Adetunji AE, Ayenale M, Akhigbe I, Akerele LO, Isibor E, Idialu J, Aideloje FO, Emuebonam E, Aire C, Adomeh DI, Odia I, Atafo RO, Okonofua MO, Owobu A, Ogbaini-Emovon E, Tobin EA, Asogun DA, Okogbenin SA, Sabeti P, Happi CT, Günther S, Azubuike CO, Rafiu M, Odike A, Olomu SC, Ibadin MO, Okokhere PO, Akpede GO. Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis. Int J Infect Dis 2020; 103:124-131. [PMID: 33176203 DOI: 10.1016/j.ijid.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 01/16/2023] Open
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.
Collapse
Affiliation(s)
- Adewale E Adetunji
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Magdalene Ayenale
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Irene Akhigbe
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Lilian O Akerele
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Efosa Isibor
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Juliet Idialu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Florence O Aideloje
- Department of Nursing Services, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekene Emuebonam
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Chris Aire
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Donatus I Adomeh
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ikponmwosa Odia
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Rebecca O Atafo
- Nursing Services Unit, Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Martha O Okonofua
- Nursing Services Unit, Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Adaugo Owobu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ephraim Ogbaini-Emovon
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekaete A Tobin
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Danny A Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sylvanus A Okogbenin
- Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Pardis Sabeti
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, United States
| | - Christian T Happi
- Department of Biological Sciences and African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, and German Center for Infection Research (DZIF), Partner site Hamburg - Lübeck - Borstel - Riems, Germany
| | | | - Mojeed Rafiu
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Angela Odike
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sylvia C Olomu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Michael O Ibadin
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Peter O Okokhere
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - George O Akpede
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
| |
Collapse
|