Acute kidney injury in hospitalized children with diphtheria in northwestern Nigeria: incidence and hospitalization outcomes.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY
Renal Failure Pub Date : 2025-12-01 Epub Date: 2025-02-23 DOI:10.1080/0886022X.2025.2465817
Olayinka Rasheed Ibrahim, Abdurrazzaq Alege, Michael Abel Alao, Olanrewaju Timothy Adedoyin
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引用次数: 0

Abstract

Background: Despite the kidney being affected by diphtheria exotoxin, the extent of acute kidney injury (AKI) and its possible impact on outcomes remain unknown. This study examined the incidence, risk factors, and outcomes of AKI in children with diphtheria.

Methods: This was a prospective cohort study of confirmed diphtheria managed from July 1, 2023, to April 30, 2024, at a health facility in Nigeria. We obtained data on clinical and laboratory features and treatments received. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria.

Results: We included 237 children with a median [interquartile range] age of 7.0 [4-10] years. Using KDIGO, 139 (58.6%) had AKI [stage 1:88 (37.1%); stage 2: 18 (7.6%); and stage 3: 33 (13.9%)]. Variables associated with AKI included age, sore throat, inability to swallow, difficulty breathing, nasal blockade, hypoxemia, nasal discharge, pallor, abnormal chest findings, hospitalization duration, vaccination status, white blood cells, lymphocytes, platelets, serum bicarbonate, sodium and potassium, and treatments received, p < 0.05. On multivariable logistic regression, predictors of AKI included age ≤ 60 months [AOR 2.75, 95% CI 1.27-5.95], dexamethasone [AOR 2.57, 95% CI 1.11-4.60], oxygen therapy [4.85, 95% CI 1.24-18.99], and ibuprofen [AOR 2.74, 95 CI% 1.16-6.44]. Mortality rate was 24.5% (58/237) and 33.1% (46/139) in AKI. The odds of deaths with AKI were 3.56 (95% CI 1.76-7.14).

Conclusion: There is a high incidence of AKI among children with diphtheria and increased odds of death. Factors that predicted AKI included younger age, oxygen therapy, and medications (ibuprofen and dexamethasone).

尼日利亚西北部白喉住院患儿的急性肾损伤:发病率和住院治疗结果。
背景:尽管肾脏受到白喉外毒素的影响,急性肾损伤(AKI)的程度及其对预后的可能影响尚不清楚。本研究调查了白喉患儿AKI的发生率、危险因素和结局。方法:这是一项从2023年7月1日至2024年4月30日在尼日利亚一家卫生机构进行的确诊白喉前瞻性队列研究。我们获得了临床和实验室特征以及所接受治疗的数据。AKI的定义采用肾脏疾病:改善全球预后(KDIGO)标准。结果:我们纳入了237名儿童,年龄中位数[四分位数间距]为7.0[4-10]岁。使用KDIGO, 139例(58.6%)患有AKI[1:88期(37.1%);第二阶段:18例(7.6%);第3期:33例(13.9%)。与AKI相关的变量包括年龄、喉咙痛、吞咽困难、呼吸困难、鼻阻塞、低氧血症、鼻分泌物、脸色苍白、胸部异常、住院时间、疫苗接种情况、白细胞、淋巴细胞、血小板、血清碳酸氢盐、钠和钾以及接受的治疗。结论:白喉患儿AKI发病率高,死亡几率增加。预测AKI的因素包括年龄较小、氧疗和药物(布洛芬和地塞米松)。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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