Prevalence, Associated Factors and Short-Term Outcomes of Acute Kidney Injury In Critically Ill children Admitted In Intensive Care Unit At Bugando Medical Centre In Mwanza Tanzania.
Amini Kassim Dimosso CUHAS/MD/4002369/T/18
Prevalence, Associated Factors and Short-Term Outcomes of Acute Kidney Injury In Critically Ill children Admitted In Intensive Care Unit At Bugando Medical Centre In Mwanza Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2023 - 41 Pages Includes References and Appendicies
1.0 INTRODUCTION
1.1 Background information
Acute kidney injury (AKI) is defined as an abrupt decline in glomerular filtration rate, with increased serum creatinine and nitrogenous waste products due to several possible etiologies(1). Incidence in the pediatric population is estimated to be 3.9 per 1,000 hospitalizations, and prevalence among children admitted to intensive care units is 26.9%(1). Despite being a condition with important incidence and morbimortality, further evidence on pathophysiology and management among the pediatric population is still lacking (1).The best available data suggest that AKI occurs in 5% and 27% of non-critically ill and critically ill children, respectively(2). Additionally, AKI and fluid overload are independently associated with worse outcomes including mortality(2). Currently, the diagnosis of AKI relies upon urine output and creatinine measurements, both of which pose unique problems in children(2). Although no specific treatments exist, strategies designed to prevent AKI are being developed and there is growing evidence that early detection may improve outcomes(2).Acute kidney injury (AKI) in children is still a major health problem with unclear epidemiology especially in resource limited settings(3,4). Clinicians treating children with AKI in these settings, face numerous challenges and therefore a better understanding of AKI is needed(5,6). The prevalence of acute kidney injury is estimated to range between 10 and 20% among adult population(6).However, a notable prevalence of 13.5% among children admitted due to different causes was previously reported(7,8).Owing to several factors, the diagnosis and burden of AKI in children differs from place to place in the world(9). Due to lack of national registries, reported incidence and prevalence of AKI from developing countries are mainly based only on reports from tertiary centers, depending on local referral system and accessibility to care(10,11). The extent of AKI among children in Tanzania is difficult to ascertain due to challenges in diagnosis and recording. Recent studies done in our country showed a higher prevalence of13.5% of renal disease among selected children population (12–15).I therefore conducted this study in order to determine the prevalence and more factors which are associated with AKI among children admitted to pediatric wards of BMC referral hospitalinnorthwestern Tanzania. This study was conducted in a Schistosomiasis high endemic area and we therefore hypothesized that the prevalence of AKI among admitted children would be high. Among other factors which might contribute to high prevalence is use of herbal medicine which is common in Tanzania(16).
1.2 Problem statement
Acute kidney injury (AKI) in children is still a major health problem with unclear epidemiology especially in resource limited settings(3,4). Most patients with moderate to severe AKI are unaware of their condition, lack understanding of risk factors for recurrent AKI, and desire more information(17). Recent studies done in our country showed a higher prevalence of renal disease among selected children population (12–15). There by this study will help in determine the prevalence, associated factors and short term outcomes which are associated with AKI.
1.3 Rationale of the study
The findings from this study will help in creating awareness and alertness on the burden of AKI in critically ill children.Knowing the prevalence and associated factors will assist the clinicians in prevention and early recognition and also to develop or to update appropriate treatment guidelinesof AKI. Hence reducing associated morbidity and mortality. Also will help the insitution and ministry of health guiding on resources allocations,training of medical personel on early detection,interventions and proper managements.
1.4 Research question
What is the prevalence, associated factors and short-term outcomes of acute kidney injury in critically ill children admitted in intensive care unit at bugando medical centre in Mwanza Tanzania?
1.5 Research objectives
1.5.1 Broad objective
Prevalence, associated factors and short-term outcomes of acute kidney injury in critically ill children admitted in intensive care unit at bugando medical centre in Mwanza Tanzania.
1.5.2 Specific objectives
1. To determine prevalence of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
2. To determine associated risk factors of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
3. To determine short-term outcomes of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
Phone: +255 28 298 3384 Fax: +255 28 298 3386 Email: vc@bugando.ac.tz Website: www.bugando.ac.tz
--Pediatrics and Child Health --Hematology--Pathology
Prevalence, Associated Factors and Short-Term Outcomes of Acute Kidney Injury In Critically Ill children Admitted In Intensive Care Unit At Bugando Medical Centre In Mwanza Tanzania. - Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS – Bugando] : ©2023 - 41 Pages Includes References and Appendicies
1.0 INTRODUCTION
1.1 Background information
Acute kidney injury (AKI) is defined as an abrupt decline in glomerular filtration rate, with increased serum creatinine and nitrogenous waste products due to several possible etiologies(1). Incidence in the pediatric population is estimated to be 3.9 per 1,000 hospitalizations, and prevalence among children admitted to intensive care units is 26.9%(1). Despite being a condition with important incidence and morbimortality, further evidence on pathophysiology and management among the pediatric population is still lacking (1).The best available data suggest that AKI occurs in 5% and 27% of non-critically ill and critically ill children, respectively(2). Additionally, AKI and fluid overload are independently associated with worse outcomes including mortality(2). Currently, the diagnosis of AKI relies upon urine output and creatinine measurements, both of which pose unique problems in children(2). Although no specific treatments exist, strategies designed to prevent AKI are being developed and there is growing evidence that early detection may improve outcomes(2).Acute kidney injury (AKI) in children is still a major health problem with unclear epidemiology especially in resource limited settings(3,4). Clinicians treating children with AKI in these settings, face numerous challenges and therefore a better understanding of AKI is needed(5,6). The prevalence of acute kidney injury is estimated to range between 10 and 20% among adult population(6).However, a notable prevalence of 13.5% among children admitted due to different causes was previously reported(7,8).Owing to several factors, the diagnosis and burden of AKI in children differs from place to place in the world(9). Due to lack of national registries, reported incidence and prevalence of AKI from developing countries are mainly based only on reports from tertiary centers, depending on local referral system and accessibility to care(10,11). The extent of AKI among children in Tanzania is difficult to ascertain due to challenges in diagnosis and recording. Recent studies done in our country showed a higher prevalence of13.5% of renal disease among selected children population (12–15).I therefore conducted this study in order to determine the prevalence and more factors which are associated with AKI among children admitted to pediatric wards of BMC referral hospitalinnorthwestern Tanzania. This study was conducted in a Schistosomiasis high endemic area and we therefore hypothesized that the prevalence of AKI among admitted children would be high. Among other factors which might contribute to high prevalence is use of herbal medicine which is common in Tanzania(16).
1.2 Problem statement
Acute kidney injury (AKI) in children is still a major health problem with unclear epidemiology especially in resource limited settings(3,4). Most patients with moderate to severe AKI are unaware of their condition, lack understanding of risk factors for recurrent AKI, and desire more information(17). Recent studies done in our country showed a higher prevalence of renal disease among selected children population (12–15). There by this study will help in determine the prevalence, associated factors and short term outcomes which are associated with AKI.
1.3 Rationale of the study
The findings from this study will help in creating awareness and alertness on the burden of AKI in critically ill children.Knowing the prevalence and associated factors will assist the clinicians in prevention and early recognition and also to develop or to update appropriate treatment guidelinesof AKI. Hence reducing associated morbidity and mortality. Also will help the insitution and ministry of health guiding on resources allocations,training of medical personel on early detection,interventions and proper managements.
1.4 Research question
What is the prevalence, associated factors and short-term outcomes of acute kidney injury in critically ill children admitted in intensive care unit at bugando medical centre in Mwanza Tanzania?
1.5 Research objectives
1.5.1 Broad objective
Prevalence, associated factors and short-term outcomes of acute kidney injury in critically ill children admitted in intensive care unit at bugando medical centre in Mwanza Tanzania.
1.5.2 Specific objectives
1. To determine prevalence of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
2. To determine associated risk factors of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
3. To determine short-term outcomes of AKI injury in critically ill children admitted in intensive care unit at Bugando Medical Centre in Mwanza Tanzania.
Phone: +255 28 298 3384 Fax: +255 28 298 3386 Email: vc@bugando.ac.tz Website: www.bugando.ac.tz
--Pediatrics and Child Health --Hematology--Pathology