PREVALENCE, ASSOCIATED FACTORS AND SHORT-TERM OUTCOMES OF ACUTE KIDNEY INJURY IN CHILDREN AGED 1 MONTH TO 12 YEARS ADMITTED IN GENERAL PAEDIATRIC WARDS AT KENYATTA NATIONAL HOSPITAL

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Abstract Introduction Acute Kidney Injury (AKI) is a growing epidemiological concern globally, with an alarming rise in disease and death among children, especially in resource-constrained countries. There is a paucity of data on AKI among all children admitted to the tertiary referral health facility in Kenya. This study used the Kidney Disease Improving Global Outcome (KDIGO) criteria to ensure no child with AKI was missed. Methodology This was a descriptive cross-sectional study conducted at Kenyatta National Hospital, a teaching and referral health facility. It targeted all children aged 1 month to 12 years admitted to the general paediatric wards. The census technique was employed, where all the eligible participants were enrolled. Data analysis was conducted using R version 4.1.2. Results A total of 532 children were enrolled in the study, with the majority being male (56.8%). The median age of the participants was 1.75 (IQR: 0.58-5), with children under 1 year being the highest at 35.9%. The prevalence of AKI was 19.9%, with younger age (p=0.004), prior medication (p=<0.001), diarrhoea (p=<0.001), vomiting (p=<0.001), and herbal intoxication (p=0.003) being the factors associated with the development of AKI. Among the participants diagnosed with AKI, 25.4% underwent dialysis. The mortality rate among the participants with AKI was 2.5 times higher (23.4%) compared to non-AKI participants (9.6%), p <0.001. Conclusion Health workers need a high index of suspicion for AKI in children presenting with signs and symptoms of acute gastroenteritis, sepsis, those with a history of herbal intoxication and those under one-year-old.