Pediatric Acute Kidney Injury in the Developing World: How Realizable is the Goal of the ZeroPreventable- Deaths- by- 2025 Initiative?

Abstract

Acute kidney injury (AKI) in children is a major health problem worldwide particularly in tropical developing countries where the annual burden of AKI is estimated to be 11.3 million cases. The dismal outcome from AKI is evidenced by the high mortality rates recorded in many of these countries. The International Society of Nephrology (ISN) recently launched a global initiative which aimed to reduce preventable deaths from AKI to zero levels by the year 2025(0by25 initiative).This review aims to highlight the epidemiology of pediatric AKI in developing countries and the mitigating factors to the 0by25 initiative.Most of the etiologies of pediatric AKI are community-acquired single diseases such as malaria, gastroenteritis and hemolytic uremic syndrome. Thus, many cases of AKI in these regions are potentially preventable through community-based interventions such as malaria prevention and oral rehydration therapy. However, several factors may mitigate the realization of the goal of the 0by25 initiative in this part of the world. These medical, economic, socio-cultural and political factors should be addressed by the authorities if the ambitious goal of this initiative is to be achieved by the end of the next decade.