{
  "abstract": "Background Historically, acute kidney injury (AKI) has been an underappreciated complication in children with severe malaria. We conducted an individual patient data meta-analysis to model the impact of AKI and its complications on inpatient mortality in African children hospitalized with malaria. Methods Studies were identified using MEDLINE, EMBASE, Scopus, and PubMed with no language restrictions, as well as through outreach at scientific meetings. Investigators were contacted about participation in the study. Eligible studies included African children hospitalized with Plasmodium falciparum malaria, a serum creatinine measurement, and mortality assessed. The primary exposure was AKI, defined using Kidney Disease Improving Global Outcomes (KDIGO) criteria based on serum creatinine. The primary outcome was all-cause in-hospital mortality, and dialysis requirement was a secondary outcome. Data were standardized and cleaned, and random-effects meta-analyses were conducted to generate pooled estimates. Results We included 18 studies involving 8 countries and 13,528 children aged 3 months to 16 years over a 33-year period with 951 deaths (7%). The frequency of KDIGO-defined AKI was 47% (95% confidence interval: 46% to 48%), with 47% of children having KDIGO-defined Stage 1 AKI, 30% having Stage 2, and 23% having Stage 3 AKI. Overall, KDIGO-defined AKI was associated with a 2.87 increased odds of mortality (95% CI 2.28 to 3.61) with a monotonic increase in mortality across AKI stage. AKI was a robust risk factor for mortality across era, sex, region, and subgroups. The KDIGO AKI definition was operationalized using simplified age-based thresholds to support bedside recognition of AKI with comparable mortality performance. The WHO-defined AKI threshold (creatinine value >3 mg/dL) occurred in 3.4% (238) of children. All 238 cases identified by WHO criteria were classified as having AKI using KDIGO and age-based definitions, but WHO missed 93% (3059/3297) of additional AKI cases. Conclusions AKI was strongly associated with mortality in African children hospitalized with malaria. Creatinine thresholds can be operationalized to facilitate early AKI recognition. These findings have clinical implications for the implementation of kidney-protective care and for enhanced monitoring of children with severe malaria. Other Funded by National Institutes of Health (1R01AI165946), registered number PROSPERO (CRD42024560012).",
  "abstract_shown": true,
  "affiliations": [
    "Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine",
    "Child Health and Development Centre, Makerere University College of Health Sciences",
    "Department of Pediatrics, Upstate Medical University",
    "Menzies School of Health Research, Charles Darwin University",
    "ISGlobal, Hospital Clínic - Universitat de Barcelona",
    "Nuffield Department of Medicine, University of Oxford",
    "Center for Kidney Health, University College London",
    "Division of Nephrology, Department of Pediatrics, Center for Acute Care Nephrology, Cincinnati Children’s Hospital Medical Center",
    "Department of Pediatrics, British Columbia Children’s Hospital, University of British Columbia",
    "Department of Pediatrics, Division of Clinical Medicine, University of Global Health Equity",
    "Department of Pediatrics, Division of Pediatric Nephrology, Texas Children’s Hospital, Baylor College of Medicine",
    "Department of Medicine, University Health Network-Toronto General Hospital, University of Toronto",
    "Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine",
    "Global Health Uganda",
    "Department of Paediatrics, Makerere University College of Health Sciences",
    "Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children’s Hospital, The Ohio State University",
    "Department of Paediatrics, University College Hospital",
    "Faculty of Medicine, Mbarara University of Science and Technology"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 25,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Caitlin Bond"
    },
    {
      "affs": [
        1
      ],
      "name": "Anthony Batte"
    },
    {
      "affs": [
        2
      ],
      "name": "Folake Afolayan"
    },
    {
      "affs": [
        3
      ],
      "name": "Nicholas M. Anstey"
    },
    {
      "affs": [
        4
      ],
      "name": "Quique Bassat"
    },
    {
      "affs": [
        5
      ],
      "name": "Philip A. Bejon"
    },
    {
      "affs": [
        5
      ],
      "name": "James A. Berkley"
    },
    {
      "affs": [
        6
      ],
      "name": "Rhys D. R. Evans"
    },
    {
      "affs": [
        7
      ],
      "name": "Stuart L. Goldstein"
    },
    {
      "affs": [
        8
      ],
      "name": "Michael T. Hawkes"
    },
    {
      "affs": [
        9
      ],
      "name": "Olayinka Ibrahim"
    },
    {
      "affs": [
        10
      ],
      "name": "Peace Imani"
    },
    {
      "affs": [
        0
      ],
      "name": "Chandy C. John"
    },
    {
      "affs": [
        11
      ],
      "name": "Kevin C. Kain"
    },
    {
      "affs": [
        12
      ],
      "name": "Claire Liepmann"
    },
    {
      "affs": [
        5
      ],
      "name": "Kevin Marsh"
    },
    {
      "affs": [
        13
      ],
      "name": "Ruth Namazzi"
    },
    {
      "affs": [
        14
      ],
      "name": "Margaret Nakuya"
    },
    {
      "affs": [
        15
      ],
      "name": "Nicole O’Brien"
    },
    {
      "affs": [
        16
      ],
      "name": "Lere P Oluwadare"
    },
    {
      "affs": [
        13
      ],
      "name": "Robert O. Opoka"
    },
    {
      "affs": [
        17
      ],
      "name": "Jonathan Sserunkuuma"
    },
    {
      "affs": [
        15
      ],
      "name": "Hunter Wynkoop"
    },
    {
      "affs": [
        12
      ],
      "name": "Andrea L. Conroy"
    },
    {
      "name": "Malaria Associated Kidney Injury and Disease Consortium in Africa (maKID-Africa)"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8ezrn9bea03d6.bib",
  "cited_by": 2,
  "doi": "10.1186/s12916-026-05072-8",
  "fulltext_url": "https://doi.org/10.1186/s12916-026-05072-8",
  "id": "8ezrn9bea03d6",
  "issns": [
    "1741-7015"
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  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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      "2727|Acute Kidney Injury Research"
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  "openalex": "W7169884396",
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  "pmid": null,
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/8ezrn9bea03d6.ris",
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      "first_seen": "2026-10-30T13:46:02Z",
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  "title": "Identification of acute kidney injury in African children hospitalized with malaria: a multinational individual participant data meta-analysis",
  "title_text": "Identification of acute kidney injury in African children hospitalized with malaria: a multinational individual participant data meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:02Z",
  "url": "https://research.draconitic.com/paper/8ezrn9bea03d6",
  "venue": "BMC Medicine",
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