Afolayan Folake M, O'Brien Nicole, Ekulu Pepe Mfutu, Furia Francis F, Mwaba Chisambo, Adedoyin Olanrewaju Timothy, Ibrahim Olayinka, Aujo Judith Caroline, Dalsuco Jessica, Bassat Quique, Batte Anthony
Department of Pediatrics and Child Health, Kwara State University Teaching Hospital, Ilorin, Nigeria.
Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Semin Nephrol. 2025 May;45(3):151621. doi: 10.1016/j.semnephrol.2025.151621. Epub 2025 May 10.
Acute kidney injury (AKI) is a common, life-threatening clinical complication of severe malaria in children associated with increased short- and long-term mortality. Malaria remains a leading cause of child mortality in Africa, where most severe malaria cases and deaths occur, and a few countries account for most of the global disease burden. While some children who develop severe malaria-associated AKI may require dialysis during hospitalization, survivors may require long-term care for chronic kidney disease, including maintenance dialysis and kidney transplant. There are variations in the availability and type of dialysis services offered across malaria-endemic African countries with major barriers to accessing kidney transplants. Access remains challenging among countries with dialysis services because these centers are usually located in selected specialized urban hospitals far from most patients. The limited number of available pediatric nephrologists in the region further impacts the delivery of specialized nephrology care. This review provides an overview of the magnitude of malaria-associated AKI in selected malaria-endemic countries, country-specific perspectives on dialysis availability and access, and kidney transplant services availability for children who develop chronic kidney disease.
急性肾损伤（AKI）是儿童重症疟疾常见的、危及生命的临床并发症，与短期和长期死亡率增加相关。疟疾仍然是非洲儿童死亡的主要原因，非洲发生了大多数重症疟疾病例和死亡，少数国家承担了全球大部分疾病负担。虽然一些患重症疟疾相关AKI的儿童在住院期间可能需要透析，但幸存者可能需要对慢性肾病进行长期护理，包括维持性透析和肾移植。在疟疾流行的非洲国家，透析服务的可及性和类型存在差异，肾移植存在重大障碍。在设有透析服务的国家，获得透析服务仍然具有挑战性，因为这些中心通常位于选定的专门城市医院，离大多数患者很远。该地区可用的儿科肾病专家数量有限，这进一步影响了专科肾病护理的提供。本综述概述了选定疟疾流行国家中疟疾相关AKI的严重程度、各国关于透析可及性和获得情况的具体观点，以及患慢性肾病儿童的肾移植服务可及性。
