Prognosis of Acute Renal Failure of the Child during Severe Malaria in Niamey-Niger

• 作者: Aboubacar Illiassou Elmoctar Seydou Toure Guillaume Mahamat Abderraman Hassane Diongole Moussa Ibrahim Hamat Ide Abdou Illiassou Soumeila Toure Moumouni Garba Salamatou Niourou Zeinabou Ma?ga Moussa Tondi
• 来源期刊: 肾脏病(英文)
• 学科: 医学
• 关键词: Acute RENAL INJURY MALARIA NIGER
• 年，卷（期）: 2018,（1）
• 页码范围: 10-17
• 页数: 8页
• 分类号: R73

摘要

Introduction: In malaria-endemic areas, acute renal failure (ARF) is one of the most serious complications, it occurs in 40% of severe forms of malaria in adults and is linked to 75% of deaths, especially when extra-renal cleaning is not available. In children, studies of ARF during malaria are limited. We have no published studies on this topic in Niger. The main objective of our study is to evaluate the prognosis of ARF during severe malaria in children. Patients and Method: This is a one-year prospective study (January 1, 2016 to December 31, 2016) conducted in the resuscitation unit of the pediatric department of the National Lamordé Hospital of Niamey (Niger). We included in the study children aged 0 to 15 years hospitalized for severe malaria with impaired renal function. Patients who had chronic renal failure or who had acute renal failure with a thick negative drop were excluded from the study. Acute renal failure is defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria basing on creatinine clearance. Results: The incidence of ARF was 12.60%. The mean age of the patients was 4.25 ± 1.3 years [8 months - 15 years]. The mean hemoglobin level was 8.2 ± 2.7 g/dl. In 54.02% of cases, the hemoglobin level is ≤5 g/dl. Mean serum creatinine was 543.7 ± 69.5 μmol/l [107 - 2500 μmol/l] and mean azotemia was 27.5 ± 3.5 mmol/l. Severe anemia (54.02%) were more related to the occurrence of ARF(with p = 0.014). According to the RIFLE classification, 55 patients (63.22%) were in the Risk stage, 18 patients (20.69%) were in the injury stage and 14 patients (16.09%) in the failure stage. All patients were placed on injectable Artesunate. The average length of hospital stay was 8.6 ± 4.5 days [5 to 22 days]. Dialysis was reported in 15/87 (17.24%). For technical and financial reasons only 8 patients were hemodialysed. Indications for dialysis were severe uremic syndrome 7 cases (8.04%), fluid overload 5 cases (5.75%) and severe hyperkalemia 3 cases (3.45%). Conclusion: The etiological fac