Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review

Olowu, Wasiu A.; Niang, Abdou; Osafo, Charlotte; Ashuntantang, Gloria; Arogundade, Fatiu A.; Porter, John D.; Naicker, Saraladevi; Luyckx, Valérie A.

doi:10.1016/s2214-109x(15)00322-8

Cited by 172 publications

(281 citation statements)

References 38 publications

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“…Besides, the proportion of infection was significantly higher in HIV-infected persons, as observed in the other series [14]. Water losses related to diarrhea and/or vomiting and gastrointestinal fungal…”

Section: Etiologysupporting

confidence: 62%

Acute Kidney Injury in HIV-Infected Versus Non-Infected Persons: What Difference?

Hubert¹

2017

J Intensive Crit Care

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Patients are younger with a female predominance in the HIV-positive group. The signs are the clinical expression of opportunistic infections related to severe immunosuppression. Anemia is more common and severe in HIV-positive patients. Infections are the leading causes of AKI with a higher proportion in the HIVpositive group. The mortality rate is high, but identical in both groups. Prognosis depends more on the severity of the disease causing acute kidney injury than on its consequences. Prevention requires early management of these risk factors.

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Section: Etiologysupporting

confidence: 62%

Acute Kidney Injury in HIV-Infected Versus Non-Infected Persons: What Difference?

Hubert¹

2017

J Intensive Crit Care

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“…This shortcoming is highlighted well in the study by Olowu et al 21 This systematic review of AKI, with a focus on sub-Saharan Africa, documents that, in 3,340 patients admitted to hospital with AKI in 13 countries in the region, the disorder was severe in most cases, with indications for dialysis in 66% of children and 70% of adults. However, only slightly more than half of children and one-third of adults received dialysis when required.…”

Section: Obstacles To Diagnosis and Treatment Of Aki In Developing Comentioning

confidence: 99%

“…This role is particularly important since the density of physicians is 0.02-0.29 per 1,000 people in many African countries, which is ten to 100 times lower than the target of the World Health Organization. 22 The study by Olowu et al 21 also showed that ~80% of children and adults with AKI in sub-Saharan Africa who required, but did not receive, dialysis die. Major barriers to access to care were erratic hospital resources and out-ofpocket costs.…”

Section: Obstacles To Diagnosis and Treatment Of Aki In Developing Comentioning

confidence: 99%

Acute kidney injury: risk factors and management challenges in developing countries

Ponce¹,

Balbi²

2016

IJNRD

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Acute kidney injury (AKI) is a major global health problem in both developed and developing nations, negatively affecting patient morbidity and responsible for an estimated 1.4 million deaths per year. Although the International Society of Nephrology set a goal of eliminating preventable deaths from AKI by 2025, implementation of this program in developing countries presents major challenges not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI in developing countries, the limited health care resources to diagnose and treat AKI, and the poor awareness of the impact of AKI on patient outcomes.

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“…AKI is a common reason for admission in intensive care unit (ICU) and its incidence increases with age (17). Infections, toxics and obstetric gynecological pathologies are the main causes of AKI in African series (6). According to Baraldi et al, drugs (35.7%) and renal hypoperfusion (30.2%) are the main etiologies in the West.…”

Section: Discussionmentioning

confidence: 99%

“…causes are dominated by infections, toxic and obstetric gynecology causes are responsible (6). AKI may occur at any age.…”

mentioning

confidence: 99%

Comparative study of community acute kidney injury in young patients versus elderly patients in an internal medicine department in Abidjan (Côte d’Ivoire)

Yao¹,

Guei²,

Tia³

et al. 2016

J Renal Inj Prev

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IntroductionAcute kidney injury (AKI) is characterized by a sudden drop in glomerular filtration rate. It is commonly seen in our medical practice. Its incidence varies from 1.9% to 24.4% depending on the series (1-4). In intensive care units, this incidence is in the order of 20% to 50% (5). The etiologies of AKI vary from one region to the other of the world. In the West countries, septic shock, hyopovolemia, cardiogenic shock and post-operative AKI are the most common in adults (4). In Africa, the Implication for health policy/practice/research/medical education:In our study, we found that regardless of age, infection is the leading cause of acute kidney injury (AKI). Drug-induced AKI is more common in young adults. On the other hand, benign tumor of the urinary tract and malignant hypertension are more found in the elderly. In addition, mortality and non-recovery of renal function are higher in the elderly. The causes of death and the factors associated with mortality and non recovery of renal function differ in both groups. Please cite this paper as: Introduction:Numerous studies have shown that the recovery of renal function was slower and less complete in the elderly patients than in adults. Objectives: To compare the profile of acute kidney injury (AKI) of the young patients with that of the elderly patients. Patients and Methods: This is a prospective study carried out during the period from January 2010 to December 2015 in the department of Nephrology-Internal Medicine of the University hospital of Treichville. The diagnosis of AKI was retained according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: The mean age of patients was 26.8 ± 6 years in the young and 69.4 ± 7 years in the elderly. The proportion of males was 51.9% (55/106) in the young patients against 77.8% (84/108) in the elderly patients (P = 0.0001). The proportion of hypertension and diabetes in the elderly patients, respectively 30.6% and 36.1% was statistically higher than in the young patients (P = 0.001). However, human immunodeficiency virus (HIV) infection was more prevalent in the young patients (P = 0.0001). Anemia was observed in 84.9% in the young patients against 58.3% in the elderly patients (P = 0.001). It was severe in 34% among the young patients against 15.7% among the elderly patients (P = 0.002). The proportion of drug AKI was 17% in the young patients against 2.8% in the elderly patients (P = 0.0001). Malignant hypertension (P = 0.002) and urinary tract tumors (P = 0.001) were more observed in the elderly patients. Mortality was 31.1% in the young patients against 47.2% in the elderly patients (P = 0.011). Conclusion:The etiologies are the same with different proportions, except malignant hypertension observed only in the elderly patients. Mortality is higher in the elderly patients.

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Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review

Abstract: None.

Cited by 172 publications

References 38 publications

Acute Kidney Injury in HIV-Infected Versus Non-Infected Persons: What Difference?

Acute Kidney Injury in HIV-Infected Versus Non-Infected Persons: What Difference?

Acute kidney injury: risk factors and management challenges in developing countries

Comparative study of community acute kidney injury in young patients versus elderly patients in an internal medicine department in Abidjan (Côte d’Ivoire)

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