Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Department of Nursing Services, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
Int J Infect Dis. 2021 Feb;103:124-131. doi: 10.1016/j.ijid.2020.11.006. Epub 2020 Nov 8.
To assess the prevalence of acute kidney injury (AKI), and its impact on outcome in hospitalized pediatric patients with Lassa fever (LF).
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.
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.
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.
评估急性肾损伤（AKI）在拉沙热（LF）住院儿科患者中的发生率及其对预后的影响。
我们回顾了 40 例连续 PCR 确诊 LF 住院儿童的临床表现和实验室特征及结局。AKI 的诊断和分期基于 KDIGO 标准。我们使用 t 检验或 χ2 检验比较组间差异，p 值<0.05 表示存在显著差异。
16 例（40%）患儿发生 AKI。AKI 患儿的病死率（CFR）为 9/16（56%），无 AKI 患儿的病死率为 1/24（4%）（AKI 相关 CFR 的比值比[95%CI]为 29.57[3.17, 275.7]）。异常出血（p=0.008）、脑病（p=0.004）、血尿伴蛋白尿（p=0.013）和血清转氨酶水平升高（p<0.02）与 AKI 发生率增加显著相关。
住院 LF 儿科患者 AKI 发生率高，与疾病严重程度/CFR 相关。高发生率突出表明需要提供血液透析，而临床表现和/或血尿伴蛋白尿可能是提示需要此类专科治疗的简易指征。
