Related Experiment Video

Updated: Jun 5, 2026

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
07:56

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Published on: January 29, 2018

AKI and Mortality in Children Hospitalized With Malnutrition

Anthony Batte1,2,3,4, Aidah Namugumya4, Denise C Hasson5

  • 1Child Health and Development Center, College of Health Sciences, Makerere University, Kampala, Uganda.

Kidney International Reports
|June 4, 2026
PubMed

Insights

Acute kidney injury (AKI) is common in malnourished children and linked to mortality when specific creatinine thresholds are used. Current risk scores are ineffective, highlighting the need for better AKI detection methods in this vulnerable group.

Area of Science:

  • Pediatric Nephrology
  • Global Health
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a frequent complication in hospitalized children.
  • Children with acute malnutrition present unique challenges for AKI diagnosis due to low baseline creatinine levels.

Purpose of the Study:

  • To determine the prevalence of AKI in children hospitalized with acute malnutrition.
  • To assess how different AKI definitions, particularly those incorporating minimum creatinine thresholds, affect risk stratification.
  • To evaluate the performance of the STOP AKI risk score in this population.

Main Methods:

  • 185 Ugandan children hospitalized with acute malnutrition were enrolled.
  • AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria with serial creatinine measurements.
  • The study evaluated the impact of minimum absolute creatinine thresholds (e.g., 0.4 mg/dl) on AKI identification and its association with mortality.

Main Results:

  • AKI, defined by KDIGO without a minimum threshold, was not associated with mortality.
  • Applying a 0.4 mg/dl minimum creatinine threshold identified AKI in 23.2% of children and was independently associated with increased mortality (aOR: 4.06).
  • The ISN STOP AKI risk score showed poor discrimination for AKI risk (AUROC: 0.50).

Conclusions:

  • Clinically meaningful AKI in malnourished children is strongly associated with mortality when appropriate creatinine thresholds are applied.
  • Standard AKI risk prediction tools perform poorly in this population.
  • There is a critical need for adapted strategies to identify AKI in children with acute malnutrition.
Abstract

Keywords:
acute kidney injuryacute malnutritionchildrendefinitionsmortalityrisk score

More Related Videos

Assessment of Child Anthropometry in a Large Epidemiologic Study09:36

Assessment of Child Anthropometry in a Large Epidemiologic Study

Published on: February 2, 2017

Related Concept Videos

Anorexia Nervosa01:28

Anorexia Nervosa

Anorexia nervosa is a complex and severe eating disorder characterized by an intense fear of weight gain, an unrelenting pursuit of thinness, and a distorted body image. It often leads to dangerously low body weight relative to an individual's age and height. This disorder is marked by significant physical and psychological consequences, making it one of the most life-threatening psychiatric illnesses.
Symptoms and Physical Effects
Individuals with anorexia nervosa commonly exhibit extreme...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Overview of Protein Metabolism01:21

Overview of Protein Metabolism

Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...