Acute kidney injury in children with nephrotic syndrome at the University of Abuja Teaching Hospital, Abuja, Nigeria: 2016 to 2021

Background: Information regarding acute kidney injury (AKI) is scarce among Nigerian children with nephrotic syndrome (NS). This study describes the prevalence, risk factors and outcomes of AKI among children with NS at the University of Abuja Teaching Hospital (UATH), Abuja, Nigeria. Materials and methods: This is a review of children with NS, from January 2016 to October 2021 at the UATH. AKI was classified by the paediatric RIFLE criteria. Results: Of the 75 children with NS, aged 13 months to 18 years, with a mean age of 10 +/- 18 years, and majorly (64, 85.3%) males. AKI occurred in 19 of 75 (25.3%) subjects comprising Failure in 15 (78.9%), Injury in 3 (15.8%) and Risk in 1 (5.3%). Regarding risk factors of AKI at hospital admission; subjects with no sepsis were at reduced odds of AKI (OR = 0.01, 95% CI = 0.02-0.06, p < 0.001); and the risk of AKI was reduced among subjects without gross haematuria (OR = 0.07, 95% CI = 0.01-0.66, p = 0.004). The likelihood of AKI increased in the presence of peritonitis (OR = 7.91, 95% CI = 2.15-29.15, p < 0.001) and urinary tract infections (UTIs) (OR = 2.55, 95% CI = 1.39-4.66, p < 0.001). Subjects with historical exposure to nephrotoxic medications (NTM) were also at risk of AKI (OR = 1.79, 95% CI = 1.13-2.84, p = 0.001). The only 2 deaths (2.6%) observed in the short term was among those with AKI (2/19, 10.5%) but full renal recovery occurred in the majority (16/19, 84.2%). Conclusions: AKI is common in our children with NS. Sepsis, gross haematuria, peritonitis, UTIs and NTM were its identified risk factors. It is prudent to have a suspicion of AKI among children with NS with these risk factors in our setting.