Evidence map›Paper›PMID 36442901›Full record

ArticleBMJ open2022

Prospective cohort study to identify prevalence, risk factors and outcomes of infection associated kidney disease in a regional hospital in Malawi.

Laura Isobel Carey, Sylvester Kaimba, Saulos Nyirenda, Karen Chetcuti, Elizabeth Joekes, Marc Yves Romain Henrion, Jamie Rylance

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.1field-weighted citation impact, top 50% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Laura Isobel CareyDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK lcarey@mlw.mw.ORCID 0000-0003-4158-4527
Sylvester KaimbaMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Saulos NyirendaDepartment of Medicine, Zomba Central Hospital, Zomba, Malawi.
Karen ChetcutiKamuzu University of Health Sciences, Blantyre, Malawi.
Elizabeth JoekesDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Marc Yves Romain HenrionDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.ORCID 0000-0003-1242-839X
Jamie RylanceDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
University of Liverpool · GBKamuzu Central Hospital · MWLiverpool School of Tropical Medicine · GB

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesAcute kidney injury (AKI) is a common and severe complication of community acquired infection, but data on impact in sub-Saharan Africa (SSA) are lacking. We determined prevalence, risk factors and outcomes of infection associated kidney disease in adults in Malawi.

designA prospective cohort study of adults admitted to hospital with infection, from February 2021 to June 2021, collecting demographic, clinical, laboratory and ultrasonography data.

settingAdults admitted to a regional hospital in Southern Region, Malawi. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcomes were prevalence of kidney disease and mortality by Cox proportional hazard model. AKI was defined according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Secondary outcomes were risk factors for AKI identified by logistic regression and prevalence of chronic kidney disease at 3 months.

resultsWe recruited 101 patients presenting to hospital with infection. Median age was 38 years (IQR: 29-48 years), 88 had known HIV status of which 53 (60%) were living with HIV, and of these 42 (79%) were receiving antiretroviral therapy. AKI was present in 33/101 at baseline, of which 18/33 (55%) cases were severe (KDIGO stage 3). At 3 months, 28/94 (30%) participants had died, while 7/61 (11%) of survivors had chronic kidney disease. AKI was associated with older age (age: 60 years vs 40 years, OR: 3.88, 95% CI 1.82 to 16.64), and HIV positivity (OR: 4.08, 95% CI 1.28 to 15.67). Living with HIV was independently associated with death (HR: 3.97, 95% CI 1.07 to 14.69).

conclusionsKidney disease is common among hospitalised adults with infection in Malawi, with significant kidney impairment identified at 3 months. Our study highlights the difficulty in diagnosing acute and chronic kidney disease, and the need for more accurate methods than creatinine based estimated glomerular filtration rate (eGFR) equations for populations in Africa. Patients with kidney impairment identified in hospital should be prioritised for follow-up.

Indexed as

Acute Kidney InjuryRenal Insufficiency, ChronicAdultHospitalsHumansMalawiMiddle AgedPrevalenceProspective StudiesRisk FactorsAcute renal failureAdult nephrologyEpidemiologyNephrology

Identifiers

PMID36442901
PMCPMC9710333
OpenAlexW4310142619

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.