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. 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. We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4 to 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. 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.

中文翻译：

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小儿马拉维创伤队列中急性肾脏损伤的发病率和流行病学：一项前瞻性观察研究。

急性肾损伤（AKI）与全世界儿童的死亡风险高度相关。创伤可导致AKI，并且是非洲小儿死亡的主要原因。但是，目前尚无有关非洲与创伤有关的儿科AKI流行病学的信息。马拉维一家三级转诊医院收治的小儿创伤患者的前瞻性队列研究。在入院期间对入院的参与者进行前瞻性随访。AKI由仅肌酸酐的肾脏疾病改善全球疗效标准定义。我们针对与AKI相关的潜在风险因素的假设生成计算了描述性统计数据和单变量相对风险（RR）。我们分析了114位参与者的数据。根据基线肌酐的定义，AKI的发病率范围为4％至10％。新的Schwartz方程最佳地估计了肌酐基线值，并产生了9.7％的AKI发生率。十分之一的儿童在住院期间死亡，但是与没有AKI的儿童相比，患有AKI的儿童（n = 4）的死亡风险显着更高（40.0％对6.2％； RR 6.5，95％CI 2.2-19.1）。烧伤最常见于AKI（63.6％）。其他潜在的AKI风险因素包括多处受伤，躯干或面部受伤，以及最近服用草药的情况。与没有AKI的患者相比，马拉维多达10％的入院小儿创伤患者发生AKI，并且死亡风险增加了7倍。巨大的无法识别的创伤负担需要研究人员，临床医生和决策者进一步投资，以开发基于证据的分类，识别，