pRIFLE and prevalence of acute kidney injury in under-five children with severe malaria: any change?

Abstract

Background: Malaria is an endemic disease in sub- Saharan Africa caused by parasites of the genus Plasmodium. Plasmodium falciparum is responsible for most of its severe complications, including cerebral malaria, severe anaemia and acute kidney injury (AKI) formerly known as acute renal failure. AKI is more commonly diagnosed in children than in adults and studies report varying prevalence among different populations. The study set out to determine the prevalence of AKI in under-5 children with severe malaria in a tertiary hospital in South-South Nigeria.

Materials and Methods: Children aged 6 - 60 months with a positive rapid diagnostic test (RDT) for malaria, who met the criteria for severe malaria were studied. Serum creatinine obtained from the subjects was used to calculate estimated creatinine clearance and AKI was stratified using the WHO and pRIFLE
criteria.

Results: Eleven of 190 subjects studied met the WHO criteria for malarial AKI, giving a prevalence of 5.8%. Of these,90.1% were children between 48 to < 59 months. More males were affected, with a male: female ratio of 1.8:1.All the children with AKI were in pRIFLE stage'F'.

Conclusion: The prevalence of malarial acute kidney injury in this study was low, males and children in the low socioeconomic class were most affected.

Keywords: Malarial Acute Kidney Injury, Prevalence, Under -5 children, pRIFLE