Patterns and Outcomes of Acute Kidney Injury among Under-Five Children attending at Nangarhar University Teaching Hospital

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Published Dec 30, 2025
https://doi.org/10.70436/nuijb.v4i04.410
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Vol. 4 No. 04 (2025): December

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Massihullah Massih
Nangarhar University
Najeebullah Ameen
Nangarhar University
Ajmal Nasiri
Nangarhar University
Abdul Ghafar Shirzad
Nangarhar University

Abstract

Background: Acute kidney injury defined as a rise in serum creatinine of ≥0.3 mg/dL within 48 hours, is a common but frequently overlooked complication among hospitalized children, especially in resource-limited countries. Acute Kidney Injury is associated with increased pediatric morbidity and mortality, yet data from Afghanistan are limited. This study aimed to determine patterns and outcome of Acute Kidney Injury and its associated risk factors among under-five children admitted to Nangarhar University Teaching Hospital.


Materials and Methods: This retrospective study was conducted at Nangarhar University Teaching Hospital using a census sampling method. Medical records of children aged 1–59 months admitted between 20 March 2024 and 21 March 2025 were reviewed. A total of 4191  under-five admissions were screened, and 197 children included in the study.


Results: Acute Kidney Injury was 26% (51/197). 64% were male and 36% were female, and 79.7% were settled in the rural area and 21,3% were in urban. Acute Kidney Injury showed no significant association with age, sex, anemia, leukocytosis and resident. However, significant associations were observed between Acute Kidney Injury and mortality (p = 0.001), prolonged length of hospital stay (p = 0.017), and exposure to nephrotoxic antibiotics, particularly Vancomycine and aminoglycosides (p = 0.001). Pneumonia, dehydration, and sepsis were the most frequent underlying conditions.


Conclusion: Acute Kidney Injury occurred in over one-quarter of under-five children admitted to the pediatric intensive care unit. It was significantly linked to higher mortality, longer hospitalization, and nephrotoxic antibiotic use.

Keywords

Acute, Kidney, Injury, Mortality, Risk, Factors, Under-five, Children

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Author Biographies

Massihullah Massih, Nangarhar University

Department of Pediatrics, Faculty of Medicine, Nangarhar University, Nangarhar, Afghanistan

Najeebullah Ameen, Nangarhar University

Department of Pediatrics, Faculty of Medicine, Nangarhar University, Nangarhar, Afghanistan

Ajmal Nasiri, Nangarhar University

Department of Neonatology, Faculty of Medicine, Nangarhar University, Nangarhar, Afghanistan

Abdul Ghafar Shirzad, Nangarhar University

Department of Biochemistry, Faculty of Medicine, Nangarhar University, Nangarhar, Afghanistan

How to Cite
Massih, M., Ameen, N., Nasiri, A., & Shirzad, A. G. (2025). Patterns and Outcomes of Acute Kidney Injury among Under-Five Children attending at Nangarhar University Teaching Hospital. Nangarhar University International Journal of Biosciences, 4(04), 18–23. https://doi.org/10.70436/nuijb.v4i04.410

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