Epidemiology and Outcomes of Paediatric Acute Kidney Injury at Lagos University Teaching Hospital, South West Nigeria

Acute kidney injury (AKI) in children is associated with significant in-hospital mortality and risk of chronic kidney disease progression, yet paediatric AKI data from West Africa remain sparse. This retrospective cohort study examines the epidemiology, aetiological spectrum, and short-term outcomes of AKI among children aged one month to 15 years at Lagos University Teaching Hospital (LUTH), Lagos State, South West Nigeria, over a four-year period from 2020 to 2023. AKI was defined and staged using the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 paediatric criteria. Records of 184 children with confirmed AKI were reviewed. Malaria-associated AKI was the most common aetiology (31.5%), followed by sepsis (24.5%), haemolytic uraemic syndrome (14.1%), and nephrotic syndrome complications (10.9%). KDIGO Stage 3 AKI was present in 39.1% of cases. Case fatality rate was 26.6%, with Stage 3 AKI and oliguria at admission being the strongest predictors of death. Dialysis was required in 21.2% of cases, but access was limited by equipment availability and cost. Renal recovery was complete in 56.4% of survivors at discharge. Among partial recovery cases, 18.6% showed persistent proteinuria suggesting residual kidney damage. The study provides evidence for the significant burden of paediatric AKI in Nigeria and recommends early AKI recognition, malaria prevention strategies, and expanded dialysis access. Keywords: acute kidney injury, KDIGO, paediatric, LUTH, South West Nigeria.