FACULTY OF CLINICAL SCIENCES

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Diagnosing renal failure due to diethylene glycol in children in a resource-constrained setting
(Springer International Publishing, 2012) "Akuse, R. M.; Anyiam, J.; Eke, F. U.; Ademola, A. D.; Fajolu, I. B.; Gbelee, H. O.; Ihejiahi, U.; Bugaje, M. A.; Anochie, I. C.; Asinobi, A. O.; Okafor, H. U.; Adeleke, S. I.; Audu, L. I.; Otuneye, A.; Disu, E.; Idris, H.; Aikhonbare, H.; Yakubu, A.; Ogala, W.; Ogunrinde, O.; Wammanda, R.; Orogade, A.; Eseigbe, E.; Umar, L.; Musa, H.; Onalo, R.; West, B.; Paul, N.; Lesi, F.; Ladapo, T.; Boyede, O.; Okeowo, R.; Mustapha, A.; Akinola, I.; Chima-Oduko, O.; Awobusuyi O.
Background In 2008, several Nigerian children developed acute kidney injury (AKI) after ingesting teething syrup contaminated with diethylene glycol (DEG). Because there are limited diagnostic facilities in resource constrained countries, this study investigated whether AKI associated with DEG could be identified by other means. Methods: This was a multicenter study. Information was obtained from hospital records. Clinicopathological features of all children withAKI over a 6-month period were reviewed. Results Sixty (50.4%) of 119 children ingested “My pikin” teething syrup. Compared to children who had not ingested it, they were significantly (p<0.05) younger (11.95 vs. 31 months), more were anuric (98.3 vs. 74.6%), hypertensive (84 vs. 52%), had severe metabolic acidosis (46.7 vs. 20.5%), and died (96.6 vs. 71.2%). They developed increasing metabolic acidosis and multiorgan dysfunction despite peritoneal dialysis. Late presentation, financial difficulties, inadequate facilities for toxicology, and hemodialysis complicated management. Conclusions Identifying AKI associated with DEG is difficult. Detailed drug history, increasing metabolic acidosis, and multiorgan deterioration despite peritoneal dialysis should arouse suspicion. Simple diagnostic tests need to be developed and facilities for hemodialysis of infants and financial support provided. Recurrences can be prevented by creating awareness, improving manufacturing practices, field-testing of drugs, and international monitoring of pharmaceuticals imported for manufacture.
Predictors and outcomes of acute kidney injury after non-cardiac paeditaric surgery.
(2019) Lawal, T.A.; Raji, Y.R.; Ajayi, S.O.; Ademola, A.D.; Ademola, O.O.; Adigun, O.O.; Ogundoyin, O.O.; Olulana, D.I.; Asinobi, A.O.; Salako, B.L.
Background: It is necessary to define the problem of acute kidney injury (AKI) after non-cardiac surgery in order to design interventions to prevent AKI. The study aimed to evaluate the occurrence, determinants and outcome of AKI among children undergoing general (non-cardiac) surgery. Methods: This was a prospective cohort study of patients aged ≤ 15 years who had general surgery over 18 months period at a tertiary hospital in Nigeria. AKI was evaluated at 6 and 24 h and within 7 days of surgery. Data were analysed using SPSS version 21. Results: A total of 93 patients were studied with age ranging from 3 days to 15 years (median = 4 years). AKI occurred within 24 h of surgery in 32 (34.4%) and cumulatively over 7 days in 33 (35.5%). Patients who had sepsis were nearly four times as likely as others to develop perioperative AKI (OR = 3.52, 95% CI 1.21, 10.20, p = 0.021). Crude mortality rate was 12.1% (4/33); no mortality was recorded among those without AKI, p = 0.014. Conclusion: Perioperative AKI occurred in 35.5% of children who underwent general (non-cardiac) surgery. Patients who had sepsis were four times more likely than others to develop AKI. Mortality was documented only in patients who had AKI.