Acute Kidney Injury in Children: A 3-Year Retrospective Analysis at Komfo Anokye Teaching Hospital, Ghana

Background/Aims: Acute kidney injury (AKI) is a fairly common condition seen in pediatric practice. It continues to be a significant contributor to preventable deaths, particularly in resource-constrained regions of the world, owing to a lack of dialysis services. AKI continues to be a major cause of death in critically ill children. Aetiology, medical setting, co-morbidities, and the availability of dialysis therapy all influence mortality outcomes. The purpose of this three-year data analysis (2010-2012) was to determine the aetiology and treatment/mortality outcomes of children with AKI who presented to a Teaching Hospital in Ghana.
Out of a total of 664 renal cases, 206 cases of AKI were recorded over the course of the study. The most common causes of AKI were hemoglobinuria, obstructive uropathy, and tumor infiltration of the kidneys (37.8 percent ). Diarrhoea accounted for 9.2 percent of cases, with glomerulonephritides accounting for 12.1 percent. Seventy-one (34.5%) of the 206 AKI cases required dialysis, which could only be provided to 25 (35.2%) of them, 16 (64%) of whom survived. 43 children (20.9 percent) died, while 144 (69.9 percent) survived. Thirty-one (72%) of the patients who died required dialysis. Conclusion: When compared to previous studies conducted around the world, there is a significant burden of AKI among hospitalized children in Kumasi, Ghana. Most cases of AKI were caused by haemoglobinuria and tumor-related conditions, rather than diarrhoea-associated conditions and postinfectious glomerulonephritis, as previously reported or postulated. The majority of AKI deaths were caused by a lack of dialysis services. Peritoneal dialysis should be promoted throughout Africa to prevent unnecessary deaths from AKI due to its lower technical requirements when compared to other modalities of renal replacement therapy.

Author (S) Details

Prof. Sampson Antwi
School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Ghana and Komfo Anokye Teaching Hospital, Ghana.

Anima Sarfo
Komfo Anokye Teaching Hospital, Ghana.

Abigail Amoah
Komfo Anokye Teaching Hospital, Ghana.

Anna Serwaa Appia
Komfo Anokye Teaching Hospital, Ghana.

Esther Obeng
Komfo Anokye Teaching Hospital, Ghana.

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