{"doi":"10.21203/rs.2.21800/v2","title":"Incidence and Epidemiology of Acute Kidney Injury in a Pediatric Malawian Trauma Cohort: a Prospective Observational Study","abstract":"Abstract Introduction Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa. Methods Prospective cohort study of pediatric trauma patients admitted to a tertiary referral hospital in Malawi. Participants enrolled at admission were followed prospectively throughout their hospitalization. AKI was defined by creatinine-only Kidney Disease Improving Global Outcomes criteria. We calculated descriptive statistics and univariate relative risks (RR) for hypothesis-generation of potential risk factors associated with AKI. Results We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4-10%. The new Schwartz equation estimated baseline creatinine values best and yielded an AKI incidence of 9.7%. Almost one in ten children died during hospitalization, but those with AKI (n=4) were at significantly higher risk of death compared to those without AKI (40.0% vs 6.2%; RR 6.5, 95% CI 2.2-19.1). Burn injuries were most commonly associated with AKI (63.6%). Other potential AKI risk factors included multiple injuries, trunk or facial injuries, and recent consumption of herbal remedies. Conclusions AKI occurs in up to 10% of admitted pediatric trauma patients in Malawi and increases the risk of death 7-fold compared to those without AKI. This large unrecognized burden in trauma requires further investment by researchers, clinicians and policymakers to develop evidenced-based triage, recognition, and management approaches to prevent the associated sequelae and potential mortality from AKI.","journal":"Research Square","year":2020,"id":133642,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5392,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":421365,"name":"William Muronya","orcid":null,"position":1,"is_corresponding":false},{"id":420428,"name":"Zachary H. Smith","orcid":"0000-0003-2926-8724","position":2,"is_corresponding":false},{"id":247062,"name":"Keisha L. Gibson","orcid":"0000-0003-4702-8150","position":3,"is_corresponding":false},{"id":269855,"name":"Amy K. Mottl","orcid":"0000-0002-4258-1726","position":4,"is_corresponding":false},{"id":324101,"name":"Anthony Charles","orcid":"0000-0001-7332-4354","position":5,"is_corresponding":false},{"id":338712,"name":"Stephen W. Marshall","orcid":"0000-0002-2664-9233","position":6,"is_corresponding":false},{"id":383773,"name":"Yvonne M. Golightly","orcid":"0000-0003-1205-2759","position":7,"is_corresponding":false},{"id":421367,"name":"Charles K. Munthali","orcid":null,"position":8,"is_corresponding":false},{"id":420429,"name":"Emily W. Gower","orcid":"0000-0003-1016-9910","position":9,"is_corresponding":false},{"id":336743,"name":"Erica C. Bjornstad","orcid":"0000-0002-4191-9510","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T23:16:20.998822Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}