title: Acute kidney injury and its association with in-hospital mortality among children with acute infections.
abstract: BACKGROUND
  We investigated prevalence of acute kidney injury (AKI) at hospitalization and its association with in-hospital mortality among Ugandan children hospitalized with common acute infections, and predictors of mortality among AKI children.
  
  
  METHODS
  We enrolled 2,055 children hospitalized with primary diagnoses of acute gastroenteritis, malaria, or pneumonia. Serum creatinine, albumin, electrolytes, hemoglobin, and urine protein were obtained on admission. Participants were assessed for AKI based on serum creatinine levels. Demographic and clinical data were obtained using a primary care provider survey and medical chart review. Logistic regression was used to determine predictors of in-hospital mortality.
  
  
  RESULTS
  A total of 278 (13.5%) of children had AKI on admission; for 76.2%, AKI was stage 2 (98/278) or stage 3 (114/278) defined as serum creatinine >2- or 3-fold above normal upper limit for age, respectively. AKI prevalence was particularly high in gastroenteritis (28.6%) and underweight children (20.7%). Twenty-five percent of children with AKI died during hospitalization, compared to 9.9% with no AKI (adjusted odds ratio (aOR) 3.5 (95% CI, 2.2-5.5)). In-hospital mortality risk did not differ by AKI stage. Predictors of in-hospital mortality among AKI children included primary diagnosis of pneumonia, aOR 4.5 (95% CI, 1.8-11.2); proteinuria, aOR = 2.1 (95% CI, 1.0-4.9) and positive human immunodeficiency virus (HIV) status, aOR 5.0 (95% CI, 2.0-12.9).
  
  
  CONCLUSIONS
  Among children hospitalized with gastroenteritis, malaria, or pneumonia, AKI at admission was common and associated with high in-hospital mortality.
authors.affiliation: Department of Epidemiology, University of Washington, Box 357236, Seattle, WA, 98195, USA, pdimani@u.washington.edu.
authors.forename: Peace D
authors.initials: PD
authors.lastname: Imani
authors.forename: Amos
authors.initials: A
authors.lastname: Odiit
authors.forename: Sangeeta R
authors.initials: SR
authors.lastname: Hingorani
authors.forename: Noel S
authors.initials: NS
authors.lastname: Weiss
authors.forename: Allison A
authors.initials: AA
authors.lastname: Eddy
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality*; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005759:Gastroenteritis / Q000150:complications / Q000401:mortality; D015658:HIV Infections / Q000382:microbiology; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000150:complications* / Q000401:mortality*; D007677:Kidney Function Tests; D016015:Logistic Models; D008288:Malaria / Q000150:complications / Q000401:mortality; D008297:Male; D016017:Odds Ratio; D011014:Pneumonia / Q000150:complications / Q000401:mortality; D015995:Prevalence; D011507:Proteinuria / Q000401:mortality; D012306:Risk; D012737:Sex Factors; D013851:Thinness / Q000401:mortality; D014454:Uganda / Q000453:epidemiology
chemical_list: D003404:Creatinine