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Folake M. Afolayan, Departments of Paediatrics & Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Olanrewaju T. Adedoyin, Departments of Paediatrics & Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria, Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
Mohammed B. Abdulkadir, Departments of Paediatrics & Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria, Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
Olayinka R. Ibrahim, Department of Pediatrics, Federal Medical Centre, Katsina State, Nigeria
Sikiru A. Biliaminu, Departments of Chemical Pathology & Immunology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Departments of Chemical Pathology & Immunology, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria, Departments of Chemical Pathology & Immunology, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
Olugbenga A. Mokuolu, Departments of Paediatrics & Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria, Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
Ayodele Ojuawo, Departments of Paediatrics & Child Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria, Departments of Paediatrics & Child Health, Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria

Abstract

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria.

Publication Date

12-21-2020

First Page

e312

Last Page

317

Creative Commons License

Creative Commons Attribution-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 International License.

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