Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis

Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis Caitlin Bond, Anthony Batte, Folake Afolayan, Nicholas Anstey, and 21 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8106913/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 16 You are reading this latest preprint version 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 severe 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 46% 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 > 3mg/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. Discussion. AKI was strongly associated with mortality in African children with severe 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). acute kidney injury severe malaria mortality KDIGO meta-analysis Africa Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Malaria remains an important global cause of morbidity and mortality in children, with 263 million cases and 597,000 associated deaths in 2023 [ 1 ]. Africa contributes to a disproportionate burden of clinical malaria cases, accounting for 94% of malaria cases and 95% of malaria deaths [ 1 ]. Severe malaria is a life-threatening condition characterized by multiple organ dysfunction [ 2 ]. Acute kidney injury (AKI) is defined as an abrupt loss of kidney excretory function over hours to days, diagnosed based on an increase in serum creatinine or a decrease in urine output [ 3 ]. An estimated 25% of pediatric hospitalizations are complicated by AKI globally [ 4 ]. AKI-associated mortality is highest in low-income settings where access to specialized nephrology care and dialysis remains limited [ 5 ]. In Africa, severe malaria is a leading cause of AKI as well as a driver of acute dialysis needs among pediatric patients [ 6 ]. Mortality associated with AKI remains unacceptably high due to delays in recognition and early management [ 7 ]. The nephrology community has developed consensus guidelines to standardize AKI recognition (e.g., the Kidney Disease: Improving Global Outcomes, KDIGO); however, these criteria have not been adopted in the definition of severe malaria in the current WHO treatment guidelines [ 2 ]. New guidelines and strategies are urgently needed to facilitate the early recognition of AKI in severe malaria to improve clinical management and mitigate the risks of AKI progression [ 8 ]. The KDIGO guidelines represent evidence-based criteria to define, classify, and stage clinically meaningful increases in serum creatinine that are associated with mortality across diverse patient populations, and support a rational age-appropriate definition of AKI [ 9 ]. In this individual-participant data meta-analysis, we evaluate the association between AKI and mortality (primary analysis). We also describe the frequency of AKI across multiple pediatric malaria cohorts, varying by geography and time. We compare AKI definitions (KDIGO and WHO) and operationalize an AKI definition to support AKI recognition in children. Finally, we examine AKI-related complications (hyperkalemia, elevated BUN) and their association with dialysis and mortality. Methods Study design We followed the Preferred Reporting Items for a Systematic Review and Meta-analysis Individual Participant Data (PRISMA-IPD) guidelines [ 10 ]. The primary exposure in this study was AKI defined by KDIGO criteria [ 11 ]. The primary outcome was in-hospital mortality. Criteria for study inclusion of individual patients in the meta-analysis required all the following: (1) age 3 months to < 18 years of age; (2) hospitalized with Plasmodium falciparum infection using blood smears or rapid diagnostic tests; (3) at least one serum creatinine measurement; and (4) hospital outcome (survival vs. non-survival) was recorded. Secondary exposures included AKI-related complications of hyperkalemia (potassium > 5.5 mmol/L) and elevated blood urea nitrogen (BUN, > 20mg/dL). Subgroup analyses were conducted by biological sex, age group, nutritional status (severe wasting), decade, and region of enrollment. Severe wasting was defined as a weight-for-height z-score < − 3 standard deviations based on WHO anthropometric age and sex-based z-scores. AKI frequency estimates were restricted to studies where creatinine was measured using an isotype dilution mass-spectrometry (IDMS)-traceable assay. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale [ 12 ] assessing study quality across three domains: 1) Selection- 6 points (representativeness of the exposed cohort, selection of the non-exposed cohort, ascertainment of exposure, demonstration that outcome of interest was not present at the beginning of the study); 2) Comparability- 2 points; 3) Outcome- 5 points (assessment of outcome, follow-up was long enough for outcomes to occur, adequacy of follow-up of cohorts) [ 12 ]. Risk of bias by study is presented in Additional File 1, Table S1 . Search strategy To identify studies for inclusion, a literature search was conducted using MEDLINE, EMBASE, Scopus, and PubMed with no language restrictions. An initial pilot was conducted to ensure the search strategy identified known articles of interest. The search included three concepts using MESH terms and keywords (MESH: creatinine) AND (MESH: malaria, falciparum; keywords: severe malaria, falciparum malaria, complicated malaria) AND (MESH: child; keywords: pediatric, infant, adolescent). The initial search was conducted on February 25th, 2022, and was repeated on February 25th, 2025. Results were extracted to Covidence for further eligibility assessment by authors CDL and ALC. Additional searches to identify studies included a search of the grey literature, a review of reference lists of published work, outreach through social media, outreach to investigators in the fields of pediatric nephrology and global health through email and conference presentations, and a review of published cohorts of children with severe malaria to determine if appropriate data were collected. Studies were eligible for inclusion if they were observational or randomized controlled trials and individual participant data were provided. Published and unpublished data were included. Studies that included a broader population of hospitalized children were eligible; however, children without malaria were excluded. Data collected using whole blood point-of-care creatinine tests were excluded due to issues of creatinine overestimation. The details of each study are provided in the supplemental methods (Additional File 2). Data management Deidentified data for each study were reviewed and cleaned to create a standard set of variables, including a study identifier, participant identifier, age, height, weight, parasite density, and additional laboratory variables (hemoglobin, potassium, blood urea nitrogen) [ 13 – 21 ]. Outcomes included death (primary) and dialysis (secondary). Each dataset was reviewed, and the data were standardized and cleaned to remove participants who were less than three months or greater than 18 years old, or those with missing creatinine or mortality information. Defining acute kidney injury AKI was defined using the 2012 KDIGO criteria [ 11 ] based on fold change in admission creatinine from baseline. Stage 1 AKI was a 1.5 to < 2.0-fold increase in creatinine, stage 2 AKI was a 2.0 to < 3.0-fold increase, stage 3 AKI was ≥ 3.0-fold increase in creatinine. Baseline creatinine was imputed assuming a normal GFR of 120mL/min per 1.73m 2 and using age-based equations to back-calculate baseline creatinine, as has been validated in the pediatric literature [ 22 ]. Children with a creatinine value less than 0.4mg/dL were not considered to have AKI, irrespective of the fold change in creatinine. Sensitivity analyses evaluating AKI by creatinine threshold and age category are presented in Additional File 1, Figure S1 . Renal impairment was defined as a creatinine > 3mg/dL (265 umol/L) based on WHO 2014 criteria [ 2 ]. AKI was operationalized using simplified age-based creatinine thresholds derived from rounded and batched estimates of baseline creatinine (Table 1 ) multiplied by the fold-change in creatinine for each stage. Table 1. Proposed Serum Creatinine-associated AKI thresholds by age AKI frequency We summarized AKI frequency descriptively by study and by calendar year. Within each study, we calculated the proportion meeting KDIGO AKI with binomial (Wald) 95% CIs and displayed an overall reference line equal to the pooled proportion (Σ cases / Σ N). To visualize temporal patterns, we aggregated by year and fit LOESS smoothed weights by annual sample size. Because creatinine assay practices changed over time, we restricted this analysis to data collected from 2008 onwards and, separately, to low-risk-of-bias studies shown in Additional File 1. Meta-analysis Individual participant data (IPD) from 18 studies across nine countries were analyzed using a two-stage approach as the primary approach. One study from Kenya was split into two time periods due to changes in creatinine assays over time [ 23 ]. Within each study, we estimated the association between AKI and in-hospital mortality with Firth logistic regression to address sparse cells and separation [ 24 ], adjusting for age in all studies and assay type only in studies that used > 1 creatinine method. Study-specific log odds ratios (ORs) were pooled using a random-effects model with restricted maximum likelihood estimation and Hartung–Knapp confidence intervals [ 25 ]. Heterogeneity was summarized with Cochran’s Q and I², and a prediction interval shown in forest plots. Sensitivity analysis included: (i) repeating the two-stage analysis with conventional logistic regression, (ii) repeating both approaches to low risk-of-bias studies, and (iii) a one-stage mixed-effects logistic model with a random intercept for study (fixed AKI effect) adjusting for age and assay type (when applicable). Subgroups. We fit separate mixed-effect logistic models (random intercept for study) for each subgrouping variable (age, decade, region, sex, assay method, severe wasting, severe malaria) including an AKI × subgroup interaction. We report contrasts (the adjusted odds ratio (aOR) for AKI) within each subgroup and show the overall AKI effect as a reference line in the plots. Secondary exposures. For secondary exposures, we evaluated hyperkalemia and elevated BUN using the same subgroup framework, adjusted for age. Because between-study heterogeneity was larger for these exposures, corresponding two-stage meta-analyses are presented in Additional File 1. Covariate strategy. We adjusted only for variables with meaningful within-study variation and a confounding role. Age was included in all models; assay type was included only in the one study with > 1 method. Variables that were constant within studies (e.g., region, decade, sex) or likely to be on the causal pathway (e.g., antimalarial regimen) were not included in the primary adjustment set, but were explored in sub-group analysis. Mediation To quantify the extent to which the AKI–mortality association operates through hyperkalemia or elevated BUN, we used logistic mediator and outcome models that included study fixed effects and study-clustered inference. Models were adjusted for age, sex, decade, and region. If fixed effects were not estimable in sparse strata, we refit without them but retained clustering. We estimated average causal mediation effects, average direct effects, total effects, and proportion mediated using quasi-Bayesian Monte Carlo with 2,000 simulations. All analyses were performed using R version 4.3.2 and Stata version 18. Data Access and Availability Source data can be found at the following link. https://doi.org/10.7910/DVN/EBQNQD (Harvard Dataverse) [ 26 ]. Results 13,528 children, aged between 3 months and 16 years, from 8 countries spanning 33 years were included in the study (Figure 1). While participant eligibility extended to 18 years, no participants older than 16 years were recruited across the studies. Most participants were from East Africa (89%) and 58% were from Kilifi, Kenya. Study characteristics are presented in Table 2. AKI frequency To assess the frequency of AKI over time, data from 2008 onward were used, following the implementation of isotope dilution mass spectrometry (IDMS)-traceable assays. Overall, 3,297 children had AKI (47% [95% CI 46% to 48%]) (Figure 2) with no difference in AKI frequency over time. Of the children with AKI, 46% had KDIGO-defined Stage 1 AKI, 30% had Stage 2, and 23% had Stage 3 and 3.4% had WHO-defined renal impairment. KDIGO-AKI frequency varied by age and was lowest in older children (under 2 years, 45%; 2-4 years, 50%; 5-9 years, 47%; 10 years or older, 38%; p<0.0001). When comparing KDIGO-defined AKI and WHO-defined renal impairment, 93% (3059/3297) of KDIGO-defined AKI cases were missed when using a threshold of 3mg/dL. When stratified by KDIGO-defined AKI stage, all WHO-defined AKI cases fell within Stage 3; yet the WHO definition still missed 63% of Stage 3 cases. AKI frequency using KDIGO definitions and minimum creatinine thresholds, as well as the WHO creatinine threshold, was modeled by age category and calendar time (Additional File 1, Figure S1). With increasing creatinine thresholds, the frequency of AKI declined and had the largest impact on children <2 years of age. Mortality The potential association between KDIGO-defined AKI and in-hospital mortality was examined across all studies, including data collected before the implementation of IDMS-traceable assays. There were 951 deaths across all studies (7.0%). The mortality rates were 9.1% among patients with AKI and 3.5% in patients without AKI, respectively. There was a decline in malaria mortality over time, with a mortality rate of 13.1% before 2000, decreasing to 7.5% between 2000 and 2010, 5.0% between 2010 and 2020, and 4.6% after 2020. Mortality rates were consistent across all age groups and did not differ by sex (7.0% in females vs. 7.1% in males). In-hospital mortality was 8.4% and 4.8% prior to and after 2011, respectively, when artemisinin-derivatives were recommended as the first-line therapy for African children with severe malaria. Association between AKI and mortality AKI was associated with a pooled odds ratio of in-hospital mortality of 2.87 (95% CI 2.28 to 3.61) across all studies (Figure 3), adjusting for age and assay method using a two-stage approach. There was a monotonic increase in mortality with increased AKI stages, with pooled mortality of 4.8%, 6.7% and 15% for stages 1 to 3, respectively (Table 2) compared to 3.5% in children without AKI. The results were comparable when calculating the fold change in creatinine from estimated baseline and simplified age-based thresholds (adjusted odds ratio 2.81 [95% CI 2.23, 3.54], Additional File 1, Figure S5). In a sensitivity analysis evaluating KDIGO-defined AKI on mortality, excluding all children who met the WHO definition of renal impairment, AKI remained a significant predictor of mortality with an odds ratio of 2.65 (95% CI 2.12 to 3.33; Additional File 1, Figure S6). Table 3. Mortality by AKI definition and stage Total N N (%) died aOR (95% CI) KDIGO-defined AKI No AKI 4398 152 (3.5) Reference Stage 1 3164 151 (4.8) 1.63 (1.28, 2.07) Stage 2 3172 212 (6.7) 2.35 (1.86, 2.97) Stage 3 2794 436 (15.0) 6.37 (5.10, 7.95) Operationalized age thresholds No AKI 5660 204 (3.6) Reference Stage 1 1340 63 (4.6) 1.36 (1.00, 1.84) Stage 2 3840 269 (7.0) 2.15 (1.76, 2.63) Stage 3 2688 416 (15.5) 5.60 (4.59, 6.83) WHO definition Renal impairment (creatinine>3mg/dL) 272 47 (17.3) 5.58 (3.86, 8.07) Mixed-effect logistic regression model adjusted for age and assay type As a sensitivity analysis, a one-stage approach was also used, which yielded a similar adjusted odds ratio (2.87 [95% CI 2.38 to 3.46], Figure 4) adjusting for age and assay method. The relationship between AKI and mortality was maintained across all pre-specified subgroups (Figure 4). Secondary outcome: dialysis Among 13,528 participants, 78 received acute dialysis (0.6%) in Uganda and Nigeria. Dialysis was first administered in 2014, with a gradual increase in access over time, with 4.7% of children with severe malaria receiving dialysis in 2024 to 2025. In studies where dialysis was available, 45/1640 (2.7%) received hemodialysis, while 11/1640 (0.7%) received peritoneal dialysis. Mortality was 18.0% in children who received dialysis and was higher among children who received peritoneal dialysis (54.6%) compared to hemodialysis (11.1%). Using mixed-effects logistic regression with a random intercept for study, mortality was 62% lower in settings with dialysis available (OR, 0.38; 95% CI, 0.25 to 0.59), adjusting for child age, sex, AKI, hyperkalemia, and uremia. Secondary exposures: hyperkalemia and elevated BUN Complications of AKI include the accumulation of nitrogenous waste products (e.g., BUN) and electrolyte abnormalities, including hyperkalemia [34]. As secondary exposures, we evaluated the relationship between elevated BUN, hyperkalemia, and mortality. Hyperkalemia occurred in 7.6% of patients, and 29.3% of children had elevated BUN. Hyperkalemia rates were highest among children under 2 years (9%) and declined with age to 5% in children >10 years (p10 years (p<0.0001). There was evidence of heterogeneity across regions for both hyperkalemia and elevated BUN, with neither associated with mortality in studies from West Africa (Figure 5). Overall, both hyperkalemia and elevated BUN were associated with mortality (pooled OR 6.04 [95% CI 5.06 to 7.21] and 2.82 [2.11 to 3.76], respectively). The effect of AKI complications hyperkalemia and elevated BUN on mortality Mediation analysis was used to evaluate the relationship between AKI and elevated BUN or hyperkalemia on mortality. Among children with hyperkalemia, 83.2% had AKI, and among children with elevated BUN, 73.4% had AKI. In causal mediation models adjusted for age, sex, decade, and region, elevated BUN explained 21% of the association between AKI and in-hospital mortality (p=0.048). Hyperkalemia explained 18% of AKI-related mortality and did not reach statistical significance (p=0.07) (Figure 6). Discussion This individual patient data meta-analysis of African children with Plasmodium falciparum malaria included data from 13,528 children collected over 33 years across eight countries. Using the KDIGO criteria, AKI occurred in 47% of children with severe malaria and is a robust and independent predictor of mortality (OR 2.87 [95% CI 2.28 to 3.61]). Subgroup analyses indicate that the high burden of AKI was consistent across time, by age, and associated with mortality across all regions in Africa. In Africa, severe malaria cases and deaths are highest in children less than 2 years of age and are less frequent amongst older children and adults due to the acquisition of naturally acquired immunity [ 35 , 36 ]. In this vulnerable population, the frequency of community-acquired AKI was 47%, with 67% of deaths occurring in the context of AKI. Previously, AKI was considered more common in older children and adults when applying a single creatinine threshold of 3mg/dL to define the disease [ 2 ]. However, when applying age-appropriate approaches to estimate baseline creatinine, the frequency of AKI was lowest in older children. The relationship between AKI and mortality across age groups emphasizes the need for increased education and awareness of AKI in young children, where AKI occurs at low creatinine thresholds compared to older children and adults. Proposed age-based thresholds to facilitate AKI recognition by age and across AKI stages are outlined in Table 1 . These thresholds are based on simplified age-based thresholds derived from baseline creatinine estimates, rounded and grouped by age to facilitate bedside recognition of AKI. This approach had comparable performance to KDIGO-defined AKI and had minimal misclassification of severe (stage 2 or 3) AKI. When evaluating AKI during an initial clinical encounter or in an epidemiological setting, baseline creatinine should be estimated, as most AKI in severe malaria is community-acquired[ 37 ]. Approaches to estimating baseline creatinine, validated in African pediatric cohorts, assume an estimated glomerular filtration rate (eGFR) of 120mL/min per 1.73m 2 and back-calculate creatinine using age-based equations [ 32 , 38 ]. One approach to mitigate the risk of over-diagnosing AKI due to imprecision in creatinine estimates involves applying a minimum creatinine threshold to define AKI [ 39 , 40 ]. Thresholds of 0.5mg/dL have been recommended in high-resource settings[ 39 ] but may not be appropriate in low-resource settings where undernutrition is common. In this population, applying a minimum threshold of 0.5mg/dL results in a significant reduction in AKI frequency, particularly in children < 2 years. Applying a minimum threshold of 0.4mg/dL prevents over-estimation at low creatinine values, where assay precision is a concern, but does not impact AKI detection in children ≥ 2 once GFR has reached its stable value. It is important to note that in children with low baseline creatinine values (e.g., younger children, children with undernutrition), AKI may occur even when the creatinine is within normal reported laboratory ranges, and failure to identify AKI in the early stages when it is amenable to interventions can result in the progression of the disease and the need for dialysis. Given the high frequency of AKI identified in this study, we suggest all children with severe malaria should be considered at high risk for the development of AKI, with simplified age-based thresholds for identifying AKI proposed. Clinicians caring for children with severe malaria should implement kidney-focused care by monitoring creatinine levels and urine output, avoiding nephrotoxic medications when possible, and paying careful attention to patient volume status. Fluid balance may be monitored by taking daily weights, using the first measurement as the anchor weight and the same scale for all measurements. While this approach has limitations in an intensive care setting, where children with AKI may be mechanically ventilated or require extracorporeal therapies, most severe malaria is managed on general wards, and taking daily weights should be a feasible approach to assess fluid balance and identify positive fluid balances that may denote fluid overload [ 41 ]. Maintaining vigilance for AKI-associated complications such as hyperkalemia, acidosis, and volume overload, and being prepared to manage them as they arise, are the cornerstones of kidney-centered care for children with malaria. The findings of differences in hyperkalemia and BUN-associated mortality in West Africa call for additional research to define the etiology of AKI-related complications across geographic contexts. However, with most participants from East Africa (89%) and 58% from Kenya, broader representation from the rest of Africa is urgently needed. Regularly dosed paracetamol for 72 hours in adults with severe falciparum malaria and severe knowlesi malaria with evidence of intravascular hemolysis showed evidence of being kidney protective in randomized controlled trials [ 42 , 43 ]. The role of regular paracetamol as a kidney protective agent in children with severe falciparum malaria in Africa is the subject of ongoing clinical trials (NCT04251351, ISRCTN84974248). Enhanced awareness of malaria as a risk factor for AKI should prompt enhanced screening for AKI complications and implementation of triage systems to guide resource allocation and transfer to higher-level facilities for advanced monitoring and dialysis, where available. Lower mortality rates in studies and centers where dialysis was available, even with limited availability, suggest that conservative measurement of AKI complications can reduce mortality independent of dialysis. Thus, increased awareness of AKI and education on how to recognize and manage AKI are critical to support AKI recovery, reduce mortality, and avert the need for dialysis [ 44 ]. For patients with worsening kidney dysfunction, early referral for organ support with dialysis should be considered. AKI-associated mortality was significantly lower when dialysis was available, even after adjusting for time, antimalarial therapy, and other clinical complications. The overall mortality rate in children with malaria receiving dialysis was 18% — lower than previous estimates of 34% in African children receiving dialysis for any cause of AKI[ 45 ]— and consistent with reports of improved survival in severe malaria-associated AKI compared to other infectious causes of AKI [ 46 ]. Hemodialysis in children is complicated by issues with vascular access, limited pediatric supplies, and risks of hemodynamic instability, making peritoneal dialysis the preferred modality for younger children. Expanded access to peritoneal dialysis using improvised materials has the potential to avert deaths [ 47 – 49 ]. Late recognition and referral may contribute to increased mortality, particularly the high mortality among children receiving peritoneal dialysis, which is often implemented as a last resort. Therefore, there is an urgent need to improve access to acute dialysis as a life-saving therapy for children with severe malaria-associated AKI, with 6 to 14% of children with severe malaria having a dialysis indication[ 28 ]. While deaths in children with severe malaria-associated AKI may not be directly attributable to AKI, severe malaria complications, including electrolyte abnormalities and acidosis, will be exacerbated and more challenging to manage when kidney function is compromised. Mediation analysis showed that up to 21% of AKI-associated mortality was partially mediated through elevated BUN (> 20mg/dL). However, it is important to note that the BUN cut-off reflects prognostic thresholds identified in children with severe malaria [ 50 ] but is well below the threshold typically associated with uremic symptoms. In the context of severe malaria, where thrombocytopenia is common, uremia (BUN > 80mg/dL) may further impact platelet function, increasing both bleeding and thrombosis risk. It can contribute to cerebral edema and raise intracranial pressure in children with neurologic findings. Additionally, uremia may increase vascular permeability, leading to pulmonary edema and respiratory failure requiring advanced respiratory support. Further, AKI was associated with hyperkalemia, and hyperkalemia was associated with mortality. Hyperkalemia is more likely to occur in patients with severe malaria due to intracellular potassium shifts from intravascular hemolysis, metabolic acidosis, and decreased potassium excretion in AKI. Emergency interventions to reduce mortality from fatal cardiac dysrhythmias include stabilizing the cardiac membrane, moving potassium intracellularly, and correcting acidosis [ 34 ]. In non-emergent settings, loop diuretics can be used to increase potassium excretion in the urine, and cation exchange resins can increase bowel losses of potassium [ 34 ]. Overall, early recognition of AKI and its complications offers opportunities for clinical interventions to prevent AKI progression, avert the need for dialysis, and reduce AKI-related mortality. This individual patient-level meta-analysis included a large sample size encompassing severe malaria hospitalizations over 33 years and representation from across Africa, demonstrating that AKI is a clear and consistent risk factor for mortality. We used a single creatinine measurement at enrollment to increase the number of eligible studies. The results remained consistent over time, independent of variations in creatinine assay methodology. While some studies had a moderate risk of bias, predominantly due to the selection of children with certain features of severe malaria (e.g., coma, dark urine), the findings were consistent across studies. Data largely reflect findings from East Africa, where malaria transmission is stable. We lack comprehensive data from Western Africa, a region characterized by seasonal malaria transmission, where a relatively high incidence of kidney risk variants (e.g., APOL1 ), which may influence susceptibility to AKI and affect kidney recovery [ 51 , 52 ]. Overall, mortality is estimated at 7% among children hospitalized with severe malaria. Assuming 597,000 malaria deaths annually, we estimate there are over 8 million severe malaria cases each year. AKI occurs in roughly 40% of children and adults with severe malaria, which equates to more than 3 million AKI cases attributable to malaria every year. Although the International Society of Nephrology aims to eliminate preventable deaths from AKI by 2025 [ 53 ], we remain far from achieving this goal. Severe malaria-associated AKI is a preventable cause of death, and public health efforts to prevent infection through vector control programs, vaccination, and early and effective treatment of infection can avert substantial morbidity and mortality. Declarations Ethics approval and consent to participate Each participating study obtained written informed consent from an institutional review board as outlined in Additional File 2 under the methods for each study. De-identified participant level data were provided for the meta-analysis. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are available in the Harvard Dataverse. https://doi.org/10.7910/DVN/EBQNQD. Competing interests The authors declare that they have no competing interests. Funding The study is funded by a National Institutes of Health project grant (R01 AI165946) through the National Institute of Allergy and Infectious Diseases (NIAID) to ALC. The Fogarty International Center of the National Institutes of Health supports this study under Award Number K43TW012586 to AB. Authors’ contributions AB, MTH, RN, NA, NOB, PI, JS, J, JB, PH, HW, ROO, LPO, RHRE, FA, OI, QB, KCK, CCJ, ALC conducted initial study recruitment and contributed source data. CB, AB CL, ALC contributed to data extraction and cleaning. CB, ALC, YZ contributed to the statistical analysis. ALC and CB drafted the manuscript with input from all authors. All authors read and approved the final manuscript. Acknowledgments We thank all the study teams for their participation and collection of data. Authors under the MaKID consortium: Caitlin Bond, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Adebowale D Ademola, College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria; Adanze O Asinobi, College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria; Folake Afolayan, Department of Pediatrics, Upstate Medical University, Syracuse, NY, USA; Nicholas Anstey, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Anthony Batte, Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda; ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Quique Bassat, ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Philip Bejon, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Deo Benyumiza, Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; James A. Berkley, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Erica Bjornstaad MD, Division of Nephrology, Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA; Andrea L. Conroy, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Global Health Uganda, Kampala, Uganda; Valerie M. Crowley, Toronto General Research Institute, University Health Network - Toronto General Hospital, Toronto, ON, Canada; Jessica Dalsuco MD, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Gavin Dreyer, Department of Nephrology, Barts Health NHS Trust, London, UK; Allison A Eddy, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada; Rhys D. R. Evans, Center for Kidney Health, University College London, London, UK; Stuart L. Goldstein, Division of Nephrology, Department of Pediatrics, Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Joseph Ogavu Gyagenda, Department of Medicine St Francis Hospital Nsambya, Kampala, Uganda; Michael T. Hawkes, Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada; Rasha Hussein, Soba University Hospital, Department of Pediatric Nephrology, Khartoum, Sudan; Olayinka Ibrahim, Department of Pediatrics, Division of Clinical Medicine, University of Global Health Equity, Kigali, Rwanda; Richard Idro, Global Health Uganda, Kampala, Uganda; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda; Peace Imani, Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA; Chandy C. John, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Kevin C. Kain, Department of Medicine, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Canada; Adeyemi Labaeka, Department of Paediatrics, University College Hospital, Ibadan, Nigeria; Claire Liepmann, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Michael Lintner-Rivera, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Kevin Marsh, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Mignon McCulloch, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Esther D Mwaikambo, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania; Shebe Mohammed, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Neema Mturi, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Ruth Namazzi, Global Health Uganda, Kampala, Uganda; Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda; Moses Ngari, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Nicole O’Brien, Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA; Babatunde O Ogunbosi, Department of Paediatrics, College of Medicine, University of Ibadan & University College Hospital, Ibadan; Regina E Oladokun, Department of Paediatrics, College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria; Lere P Oluwadare, Department of Paediatrics, University College Hospital, Ibadan, Nigeria; Robert O. Opoka, Aga Khan University Medical College Africa, Nairobi, Kenya; Jie Ren, Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, USA; Chelsea E. Sanyu, Faculty of Medicine, Busitema University, Mbale, Uganda; Karl B. Seydel, Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, Michigan; Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi; Cara Slagle, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA; Danielle E. Soranno, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA; Jonathan Sserunkuuma, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Derby Tembo, Chipata Central Hospital, Department of Pediatrics and Child Health, Chipata, Zambia; Rosauro Varo MD, Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Barcelona, Spain, Facultat de Medicina i Ciències de la Salut, Unviersitat de Barcelona (UB), Barcelona, Spain; Hunter Wynkoop, Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. References WHO: World malaria report 2024: addressing inequity in the global malaria response . In . Edited by World Health Organization. Geneva; 2024. World Health Organization: Severe malaria . Trop Med Int Health 2014, 19 Suppl 1 :7-131. Kellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ: Acute kidney injury . Nat Rev Dis Primers 2021, 7 (1):52. Meena J, Mathew G, Kumar J, Chanchlani R: Incidence of Acute Kidney Injury in Hospitalized Children: A Meta-analysis . Pediatrics 2023, 151 (2). Susantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, Jaber BL, Acute Kidney Injury Advisory Group of the American Society of N: World incidence of AKI: a meta-analysis . Clin J Am Soc Nephrol 2013, 8 (9):1482-1493. Mwaba C, Munsaka S, Bvulani B, Mwakazanga D, Chiluba BC, Fitzwanga K, Mpabalwani E: Malaria is the leading cause of acute kidney injury among a Zambian paediatric renal service cohort retrospectively evaluated for aetiologies, predictors of the need for dialysis, and outcomes . PLoS One 2023, 18 (10):e0293037. Kher V, Srisawat N, Noiri E, Gharbi MB, Shetty MS, Yang L, Bagga A, Chakravarthi R, Mehta R, Group C: Prevention and therapy of acute kidney injury in the developing world . Kidney Int Rep 2017, 2 (4):544-558. Batte A, Luyckx VA, Taylor TE, Conroy AL: Malaria guidelines fall short in diagnosing acute kidney injury . Lancet Glob Health 2024, 12 (2):e194-e196. KDIGO: Notice . Kidney Int Suppl (2011) 2012, 2 (1):1-138. Stewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, Tierney JF, Group ftP-ID: Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data: The PRISMA-IPD Statement . JAMA 2015, 313 (16):1657-1665. Kellum JA, Lameire N, Aspelin P: Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury . Kidney Int Suppl 2012, 2 . Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P: The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses . In . : Oxford; 2000. Anstey NM, Weinberg JB, Hassanali MY, Mwaikambo ED, Manyenga D, Misukonis MA, Arnelle DR, Hollis D, McDonald MI, Granger DL: Nitric oxide in Tanzanian children with malaria: inverse relationship between malaria severity and nitric oxide production/nitric oxide synthase type 2 expression . J Exp Med 1996, 184 (2):557-567. Evans RD, Hemmila U, Craik A, Mtekateka M, Hamilton F, Kawale Z, Kirwan CJ, Dobbie H, Dreyer G: Incidence, aetiology and outcome of community-acquired acute kidney injury in medical admissions in Malawi . BMC Nephrol 2017, 18 (1):21. Conroy AL, Hawkes M, Elphinstone RE, Morgan C, Hermann L, Barker KR, Namasopo S, Opoka RO, John CC, Liles WC et al : Acute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated With Increased Mortality . Open Forum Infect Dis 2016, 3 (2):ofw046. Conroy AL, Opoka RO, Bangirana P, Idro R, Ssenkusu JM, Datta D, Hodges JS, Morgan C, John CC: Acute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria . BMC Med 2019, 17 (1):98. Hawkes MT, Leligdowicz A, Batte A, Situma G, Zhong K, Namasopo S, Opoka RO, Kain KC, Conroy AL: Pathophysiology of Acute Kidney Injury in Malaria and Non-Malarial Febrile Illness: A Prospective Cohort Study . Pathogens 2022, 11 (4). Namazzi R, Batte A, Opoka RO, Bangirana P, Schwaderer AL, Berrens Z, Datta D, Goings M, Ssenkusu JM, Goldstein SL et al : Acute kidney injury, persistent kidney disease, and post-discharge morbidity and mortality in severe malaria in children: A prospective cohort study . EClinicalMedicine 2022, 44 :101292. Tembo D, Mwanza S, Mwaba C, Dallah I, wa Somwe S, Seydel KB, Birbeck GL: Risk factors for acute kidney injury at presentation among children with CNS malaria: a case control study . Malaria journal 2022, 21 (1):310. Varo R, Crowley VM, Mucasse H, Sitoe A, Bramugy J, Serghides L, Weckman AM, Erice C, Bila R, Vitorino P et al : Adjunctive rosiglitazone treatment for severe paediatric malaria: a randomized placebo-controlled trial in Mozambican children . Int J Infect Dis 2023. Batte A, Nakulima V, Namazzi R, Aujo JC, Starr MC, Schwaderer AL, Lintner-Rivera M, Ahumwire A, Ogwal D, Tenywa E et al : Malaria associated pathogenesis of chronic kidney disease (MAP-CKD): a prospective study of children hospitalized with severe malaria . BMC Nephrology 2025, 26 (1):390. Pottel H, Hoste L, Martens F: A simple height-independent equation for estimating glomerular filtration rate in children . Pediatr Nephrol 2012, 27 . Njuguna P, Maitland K, Nyaguara A, Mwanga D, Mogeni P, Mturi N, Mohammed S, Mwambingu G, Ngetsa C, Awuondo K et al : Observational study: 27 years of severe malaria surveillance in Kilifi, Kenya . BMC Med 2019, 17 (1):124. Firth D: Bias reduction of maximum likelihood estimates . Biometrika 1993, 80 (1):27-38. Hartung J, Knapp G: A refined method for the meta-analysis of controlled clinical trials with binary outcome . Stat Med 2001, 20 (24):3875-3889. Conroy A: Replication Data for: Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis . In . , DRAFT VERSION edn: Harvard Dataverse; 2025. Imani PD, Odiit A, Hingorani SR, Weiss NS, Eddy AA: Acute kidney injury and its association with in-hospital mortality among children with acute infections . Pediatr Nephrol 2013, 28 (11):2199-2206. Namazzi R, Opoka R, Datta D, Bangirana P, Batte A, Berrens Z, Goings MJ, Schwaderer AL, Conroy AL, John CC: Acute Kidney Injury Interacts With Coma, Acidosis, and Impaired Perfusion to Significantly Increase Risk of Death in Children With Severe Malaria . Clin Infect Dis 2022, 75 (9):1511-1519. Conradi N, Opoka RO, Mian Q, Conroy AL, Hermann LL, Charles O, Amone J, Nabwire J, Lee BE, Saleh A et al : Solar-powered O(2) delivery for the treatment of children with hypoxaemia in Uganda: a stepped-wedge, cluster randomised controlled trial . Lancet 2024, 403 (10428):756-765. Nakuya M, Batte A, Musiime V: Prevalence and factors associated with Acute Kidney Injury among children aged 6month- 12years passing dark urine admitted at Soroti Regional Referral Hospital: A cross-sectional study . Res Sq 2023. Afolayan FM, Adedoyin OT, Abdulkadir MB, Ibrahim OR, Biliaminu SA, Mokuolu OA, Ojuawo A: Acute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels . Sultan Qaboos Univ Med J 2020, 20 (4):e312-e317. Ibrahim OR, Afolayan FM, Alao MA, Mohammed B, Suleiman BM, Adedoyin OT: Impact of methods of estimating baseline Serum Creatinine (bSCr) on the incidence and outcomes of acute kidney injury in childhood severe malaria . Egyptian Pediatric Association Gazette 2023, 71 (1):36. Oluwadare LP, Oladokun RE, Ogunbosi BO, Labaeka AA, Taiwo OJ: Clinical Epidemiology and Geospatial Distribution of Cases of Severe Malaria in Children at a Tertiary Care Health Facility in Southwest Nigeria . International Journal of Medicine and Health Development 2025, 30 (2). Lintner-Rivera M, Bhutta A, Namazzi R, Bond C, Conroy AL, Batte A: Hyperkalemia in Pediatric Severe Malaria . Semin Nephrol 2025, 45 (3):151620. Carneiro I, Roca-Feltrer A, Griffin JT, Smith L, Tanner M, Schellenberg JA, Greenwood B, Schellenberg D: Age-patterns of malaria vary with severity, transmission intensity and seasonality in sub-Saharan Africa: a systematic review and pooled analysis . PLoS One 2010, 5 (2):e8988. Abdullah S, Adazu K, Masanja H, Diallo D, Hodgson A, Ilboudo-Sanogo E, Nhacolo A, Owusu-Agyei S, Thompson R, Smith T et al : Patterns of Age-Specific Mortality in Children in Endemic Areas of Sub-Saharan Africa . The American Journal of Tropical Medicine and Hygiene 2007, 77 (6_Suppl):99-105. Batte A, Berrens Z, Murphy K, Mufumba I, Sarangam ML, Hawkes MT, Conroy AL: Malaria-Associated Acute Kidney Injury in African Children: Prevalence, Pathophysiology, Impact, and Management Challenges . Int J Nephrol Renovasc Dis 2021, 14 :235-253. Batte A, Starr MC, Schwaderer AL, Opoka RO, Namazzi R, Phelps Nishiguchi ES, Ssenkusu JM, John CC, Conroy AL: Methods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study . BMC Nephrol 2020, 21 (1):417. Selewski DT, Cornell TT, Heung M, Troost JP, Ehrmann BJ, Lombel RM, Blatt NB, Luckritz K, Hieber S, Gajarski R et al : Validation of the KDIGO acute kidney injury criteria in a pediatric critical care population . Intensive Care Medicine 2014, 40 (10):1481-1488. Kuai Y, Li M, Chen J, Jiang Z, Bai Z, Huang H, Wei L, Liu N, Li X, Lu G et al : Comparison of diagnostic criteria for acute kidney injury in critically ill children: a multicenter cohort study . Crit Care 2022, 26 (1):207. Selewski DT, Barhight MF, Bjornstad EC, Ricci Z, de Sousa Tavares M, Akcan-Arikan A, Goldstein SL, Basu R, Bagshaw SM: Fluid assessment, fluid balance, and fluid overload in sick children: a report from the Pediatric Acute Disease Quality Initiative (ADQI) conference . Pediatr Nephrol 2023. Cooper DJ, Grigg MJ, Plewes K, Rajahram GS, Piera KA, William T, Menon J, Koleth G, Edstein MD, Birrell GW et al : The Effect of Regularly Dosed Acetaminophen vs No Acetaminophen on Renal Function in Plasmodium knowlesi Malaria (PACKNOW): A Randomized, Controlled Trial . Clin Infect Dis 2022, 75 (8):1379-1388. Plewes K, Kingston HWF, Ghose A, Wattanakul T, Hassan MMU, Haider MS, Dutta PK, Islam MA, Alam S, Jahangir SM et al : Acetaminophen as a Renoprotective Adjunctive Treatment in Patients With Severe and Moderately Severe Falciparum Malaria: A Randomized, Controlled, Open-Label Trial . Clin Infect Dis 2018, 67 (7):991-999. Mottes T, Menon S, Conroy A, Jetton J, Dolan K, Arikan AA, Basu RK, Goldstein SL, Symons JM, Alobaidi R et al : Pediatric AKI in the real world: changing outcomes through education and advocacy-a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference . Pediatr Nephrol 2023. Olowu WA, Niang A, Osafo C, Ashuntantang G, Arogundade FA, Porter J, Naicker S, Luyckx VA: Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review . Lancet Glob Health 2016, 4 (4):e242-250. Ademola AD, Asinobi AO, Alao MA, Wade AW: Paediatric Dialysis at a Tertiary Hospital in South-West Nigeria: A 4-Year Report . Blood Purif 2022, 51 (12):1015-1021. Nourse P, Cullis B, Finkelstein F, Numanoglu A, Warady B, Antwi S, McCulloch M: ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 Update (paediatrics) . Perit Dial Int 2021, 41 (2):139-157. Nkoy AB, Ndiyo YM, Matoka TT, Odio BM, Kazadi OK, Aloni MN, Collard L, McCulloch M, Ngiyulu RM, Gini JE et al : A promising pediatric peritoneal dialysis experience in a resource-limited setting with the support of saving young lives program . Perit Dial Int 2020, 40 (5):504-508. McCulloch MI, Nourse P, Argent AC: Use of locally prepared peritoneal dialysis (PD) fluid for acute PD in children and infants in Africa . Perit Dial Int 2020, 40 (5):441-445. von Seidlein L, Olaosebikan R, Hendriksen IC, Lee SJ, Adedoyin OT, Agbenyega T, Nguah SB, Bojang K, Deen JL, Evans J et al : Predicting the clinical outcome of severe falciparum malaria in african children: findings from a large randomized trial . Clin Infect Dis 2012, 54 (8):1080-1090. Hung AM, Shah SC, Bick AG, Yu Z, Chen HC, Hunt CM, Wendt F, Wilson O, Greevy RA, Chung CP et al : APOL1 Risk Variants, Acute Kidney Injury, and Death in Participants With African Ancestry Hospitalized With COVID-19 From the Million Veteran Program . JAMA Intern Med 2022, 182 (4):386-395. Gbadegesin RA, Ulasi I, Ajayi S, Raji Y, Olanrewaju T, Osafo C, Ademola AD, Asinobi A, Winkler CA, Burke D et al : APOL1 Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans . N Engl J Med 2024, 0 (0). Mehta RL, Cerda J, Burdmann EA, Tonelli M, Garcia-Garcia G, Jha V, Susantitaphong P, Rocco M, Vanholder R, Sever MS et al : International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology . Lancet 2015, 385 (9987):2616-2643. Table Table 2 is available in the Supplementary Files section Additional Declarations No competing interests reported. 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15:51:00","extension":"html","order_by":65,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":222285,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/1f993609123a869f7332bfdd.html"},{"id":96604995,"identity":"64a0723c-6d53-4b11-833a-b9bc7214c51c","added_by":"auto","created_at":"2025-11-24 09:17:13","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":139814,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlow chart of search strategy and map depicting countries represented.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/363958e84306335eda3c6161.png"},{"id":96566113,"identity":"e796f8de-a903-469f-a7e9-e8786b96aac2","added_by":"auto","created_at":"2025-11-23 15:50:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":249872,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAcute kidney injury (AKI) frequency across studies and over time\u003c/strong\u003e. a) Proportion of children with AKI across included studies after 2007, using KDIGO criteria. Bars represent point estimates of AKI frequency, and black error bars indicate 95% confidence intervals based on binomial standard errors. Total case numbers and sample sizes are displayed on the right. The red dashed line indicates the overall pooled AKI frequency. b) Smoothed temporal trend in AKI frequency from 2008 to 2025. The top panel shows LOESS curves (black lines), according to AKI definition, fit to annual AKI proportions, with shaded gray ribbons indicating 95% confidence interval. The bottom panel shows total sample sizes with available creatinine data for each year. c) Flow diagram showing classification concordance between three AKI definitions. KDIGO-defined AKI stages (left) are mapped to the operationalized age-based definition (center) and WHO renal impairment criteria (right). Colored bars indicate AKI presence according to definition, with percentages showing the proportion of the total cohort in each category. \u003cem\u003eThe Sserunkuuma, Uganda (2019–2023) study is not shown in panel b, since year of enrollment was not recorded for individual participants (only overall totals were available). See Supplemental Figure S2 for a version of this figure only including studies with low risk-of-bias.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/7d44fd4dde892233b8bb75a3.png"},{"id":96566112,"identity":"068a04f9-3cea-4297-8ada-a9baecb8d483","added_by":"auto","created_at":"2025-11-23 15:50:58","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":286627,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAssociation between acute kidney injury (AKI) and mortality in African children with severe malaria. \u003c/strong\u003eForest plot of age- and assay-adjusted odds ratios (aOR) for mortality associated with KDIGO-defined AKI, estimated using Firth logistic regression. Each square represents the study-specific effect estimate; horizontal lines indicate 95% confidence intervals. Square size is proportional to the study’s weight in the meta-analysis. The diamond shows the pooled random-effects estimate with its 95% confidence interval, while the red bar indicates the prediction interval (the expected range of effects in future similar studies). Numbers in the table denote, for each study: deaths and totals among participants with AKI, and deaths and totals among participants without AKI. Sensitivity analysis shown in Additional File 1, Supplemental Figures S2 and S3. \u003cem\u003eNjuguna, Kenya, was separated into two study periods (1993–2007 and 2008–2016). Adjustment for assay type was applied only in studies where more than one method was used.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/444d35ebaceb1d9b1d28d22d.png"},{"id":96566125,"identity":"ad86c9de-3ac7-4856-b130-e6a1778d0c84","added_by":"auto","created_at":"2025-11-23 15:50:59","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":109672,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eRelationship between AKI and mortality across sub-groups. \u003c/strong\u003eA separate mixed effect logistic regression model was fit for each sub-group, adjusting for age and assay type if appropriate. The dashed line and shaded are represent the overall effect of AKI on mortality (adjusted odds ratio [aOR] and 95% confidence interval [CI], adjusted for age and assay, using a one-stage approach. \u0026nbsp;Values shown in Additional File 1, Table S2.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/a6703d9d3c78e388152f2b72.png"},{"id":96605471,"identity":"2323737a-06b4-4a5c-8978-a01836dc3d6b","added_by":"auto","created_at":"2025-11-24 09:23:09","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":135567,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eRelationship between hyperkalemia and elevated BUN on mortality.\u003c/strong\u003e A separate mixed effect logistic regression model was fit for each sub-group, adjusting for age. The dashed line and shaded area represent the overall effect of hyperkalemia (a) or elevated BUN (b) on mortality (adjusted odds ratio [aOR] and 95% confidence interval [CI], adjusted for age. Values shown in Additional File 1, Tables S3 and S4. Two-stage analysis shown in Additional File 1, Figure S4\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/3d602ca01ef0f543977723ea.png"},{"id":96566134,"identity":"581197ff-61bc-42b3-a5df-aa0eac656c95","added_by":"auto","created_at":"2025-11-23 15:50:59","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":135594,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCausal mediation of the association between acute kidney injury (AKI) and in-hospital mortality by (a) hyperkalemia and (b) elevated BUN.\u003c/strong\u003e Left panels show adjusted odds ratios (aOR) for the AKI-mediator association and mediator-mortality association; the dashed arrow depicts the direct AKI-mortality path for context. Models are adjusted for age, sex, decade, and region. Right panels display the average causal mediation effect (ACME), average direct effect (ADE), and total effect (ACME + ADE) on the risk-difference scale reported as percentage points (pp) with 95% confidence intervals. Black/solid denotes significant mediation (ACME p\u0026lt;0.05); grey denotes non-significant mediation. “% mediated” and its 95% CI are derived from the mediation model.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/997de867ac06371f7f6edff7.png"},{"id":97136155,"identity":"28c07897-21fc-4bcf-8c19-7f73cd3097ea","added_by":"auto","created_at":"2025-12-01 09:55:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4393216,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/c986735f-707c-486d-bb5a-e1b68b6a3147.pdf"},{"id":96566116,"identity":"7eb459e5-ae4c-4216-833b-c934fce42746","added_by":"auto","created_at":"2025-11-23 15:50:58","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":2329105,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile1IPDAKIFiguresandTablessubmit.docx","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/1cde46a59487b9e0dade8b84.docx"},{"id":96566121,"identity":"a170bcfc-fa82-4a5c-bb63-fe98129cb1de","added_by":"auto","created_at":"2025-11-23 15:50:58","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":59143,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile2IPDAKIMethods.docx","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/b47760ec742d051bd4d5ac3c.docx"},{"id":96605933,"identity":"d63142b1-0dcb-43cd-a727-6f7f5a428a3d","added_by":"auto","created_at":"2025-11-24 09:24:24","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":17600,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile3IPDAKIExplanationofNsfordifferentanalyses.docx","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/0449b98719553ff5beade6cc.docx"},{"id":96566118,"identity":"2faad2e5-850f-402d-b8a5-ada654d3818d","added_by":"auto","created_at":"2025-11-23 15:50:58","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":61730,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-8106913/v1/122edfa9314a69cefbf86d39.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMalaria remains an important global cause of morbidity and mortality in children, with 263\u0026nbsp;million cases and 597,000 associated deaths in 2023 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Africa contributes to a disproportionate burden of clinical malaria cases, accounting for 94% of malaria cases and 95% of malaria deaths [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Severe malaria is a life-threatening condition characterized by multiple organ dysfunction [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Acute kidney injury (AKI) is defined as an abrupt loss of kidney excretory function over hours to days, diagnosed based on an increase in serum creatinine or a decrease in urine output [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. An estimated 25% of pediatric hospitalizations are complicated by AKI globally [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. AKI-associated mortality is highest in low-income settings where access to specialized nephrology care and dialysis remains limited [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In Africa, severe malaria is a leading cause of AKI as well as a driver of acute dialysis needs among pediatric patients [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Mortality associated with AKI remains unacceptably high due to delays in recognition and early management [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe nephrology community has developed consensus guidelines to standardize AKI recognition (e.g., the Kidney Disease: Improving Global Outcomes, KDIGO); however, these criteria have not been adopted in the definition of severe malaria in the current WHO treatment guidelines [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. New guidelines and strategies are urgently needed to facilitate the early recognition of AKI in severe malaria to improve clinical management and mitigate the risks of AKI progression [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The KDIGO guidelines represent evidence-based criteria to define, classify, and stage clinically meaningful increases in serum creatinine that are associated with mortality across diverse patient populations, and support a rational age-appropriate definition of AKI [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn this individual-participant data meta-analysis, we evaluate the association between AKI and mortality (primary analysis). We also describe the frequency of AKI across multiple pediatric malaria cohorts, varying by geography and time. We compare AKI definitions (KDIGO and WHO) and operationalize an AKI definition to support AKI recognition in children. Finally, we examine AKI-related complications (hyperkalemia, elevated BUN) and their association with dialysis and mortality.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy design\u003c/h2\u003e\n \u003cp\u003eWe followed the Preferred Reporting Items for a Systematic Review and Meta-analysis Individual Participant Data (PRISMA-IPD) guidelines [\u003cspan class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\n \u003cp\u003eThe primary exposure in this study was AKI defined by KDIGO criteria [\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e]. The primary outcome was in-hospital mortality. Criteria for study inclusion of individual patients in the meta-analysis required all the following: (1) age 3 months to \u0026lt;\u0026thinsp;18 years of age; (2) hospitalized with \u003cem\u003ePlasmodium falciparum\u003c/em\u003e infection using blood smears or rapid diagnostic tests; (3) at least one serum creatinine measurement; and (4) hospital outcome (survival vs. non-survival) was recorded. Secondary exposures included AKI-related complications of hyperkalemia (potassium\u0026thinsp;\u0026gt;\u0026thinsp;5.5 mmol/L) and elevated blood urea nitrogen (BUN, \u0026gt;\u0026thinsp;20mg/dL). Subgroup analyses were conducted by biological sex, age group, nutritional status (severe wasting), decade, and region of enrollment. Severe wasting was defined as a weight-for-height z-score\u0026thinsp;\u0026lt;\u0026thinsp;\u0026minus;\u0026thinsp;3 standard deviations based on WHO anthropometric age and sex-based z-scores. AKI frequency estimates were restricted to studies where creatinine was measured using an isotype dilution mass-spectrometry (IDMS)-traceable assay. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e] assessing study quality across three domains: 1) Selection- 6 points (representativeness of the exposed cohort, selection of the non-exposed cohort, ascertainment of exposure, demonstration that outcome of interest was not present at the beginning of the study); 2) Comparability- 2 points; 3) Outcome- 5 points (assessment of outcome, follow-up was long enough for outcomes to occur, adequacy of follow-up of cohorts) [\u003cspan class=\"CitationRef\"\u003e12\u003c/span\u003e]. Risk of bias by study is presented in Additional File 1, Table \u003cspan class=\"InternalRef\"\u003eS1\u003c/span\u003e.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eSearch strategy\u003c/h3\u003e\n\u003cp\u003eTo identify studies for inclusion, a literature search was conducted using MEDLINE, EMBASE, Scopus, and PubMed with no language restrictions. An initial pilot was conducted to ensure the search strategy identified known articles of interest. The search included three concepts using MESH terms and keywords (MESH: creatinine) AND (MESH: malaria, falciparum; keywords: severe malaria, falciparum malaria, complicated malaria) AND (MESH: child; keywords: pediatric, infant, adolescent). The initial search was conducted on February 25th, 2022, and was repeated on February 25th, 2025. Results were extracted to Covidence for further eligibility assessment by authors CDL and ALC. Additional searches to identify studies included a search of the grey literature, a review of reference lists of published work, outreach through social media, outreach to investigators in the fields of pediatric nephrology and global health through email and conference presentations, and a review of published cohorts of children with severe malaria to determine if appropriate data were collected.\u003c/p\u003e\n\u003cp\u003eStudies were eligible for inclusion if they were observational or randomized controlled trials and individual participant data were provided. Published and unpublished data were included. Studies that included a broader population of hospitalized children were eligible; however, children without malaria were excluded. Data collected using whole blood point-of-care creatinine tests were excluded due to issues of creatinine overestimation. The details of each study are provided in the supplemental methods (Additional File 2).\u003c/p\u003e\n\u003ch3\u003eData management\u003c/h3\u003e\n\u003cp\u003eDeidentified data for each study were reviewed and cleaned to create a standard set of variables, including a study identifier, participant identifier, age, height, weight, parasite density, and additional laboratory variables (hemoglobin, potassium, blood urea nitrogen) [\u003cspan class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e21\u003c/span\u003e]. Outcomes included death (primary) and dialysis (secondary). Each dataset was reviewed, and the data were standardized and cleaned to remove participants who were less than three months or greater than 18 years old, or those with missing creatinine or mortality information.\u003c/p\u003e\n\u003ch3\u003eDefining acute kidney injury\u003c/h3\u003e\n\u003cp\u003eAKI was defined using the 2012 KDIGO criteria [\u003cspan class=\"CitationRef\"\u003e11\u003c/span\u003e] based on fold change in admission creatinine from baseline. Stage 1 AKI was a 1.5 to \u0026lt;\u0026thinsp;2.0-fold increase in creatinine, stage 2 AKI was a 2.0 to \u0026lt;\u0026thinsp;3.0-fold increase, stage 3 AKI was \u0026ge;\u0026thinsp;3.0-fold increase in creatinine. Baseline creatinine was imputed assuming a normal GFR of 120mL/min per 1.73m\u003csup\u003e2\u003c/sup\u003e and using age-based equations to back-calculate baseline creatinine, as has been validated in the pediatric literature [\u003cspan class=\"CitationRef\"\u003e22\u003c/span\u003e]. Children with a creatinine value less than 0.4mg/dL were not considered to have AKI, irrespective of the fold change in creatinine. Sensitivity analyses evaluating AKI by creatinine threshold and age category are presented in Additional File 1, Figure \u003cspan class=\"InternalRef\"\u003eS1\u003c/span\u003e. Renal impairment was defined as a creatinine\u0026thinsp;\u0026gt;\u0026thinsp;3mg/dL (265 umol/L) based on WHO 2014 criteria [\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e]. AKI was operationalized using simplified age-based creatinine thresholds derived from rounded and batched estimates of baseline creatinine (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) multiplied by the fold-change in creatinine for each stage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Proposed Serum Creatinine-associated AKI thresholds by age\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cimg 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\"\u003e\u003c/div\u003e\n\u003c/div\u003e\n\u003ch3\u003eAKI frequency\u003c/h3\u003e\n\u003cp\u003eWe summarized AKI frequency descriptively by study and by calendar year. Within each study, we calculated the proportion meeting KDIGO AKI with binomial (Wald) 95% CIs and displayed an overall reference line equal to the pooled proportion (\u0026Sigma; cases / \u0026Sigma; N). To visualize temporal patterns, we aggregated by year and fit LOESS smoothed weights by annual sample size. Because creatinine assay practices changed over time, we restricted this analysis to data collected from 2008 onwards and, separately, to low-risk-of-bias studies shown in Additional File 1.\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eMeta-analysis\u003c/h2\u003e\n \u003cp\u003eIndividual participant data (IPD) from 18 studies across nine countries were analyzed using a two-stage approach as the primary approach. One study from Kenya was split into two time periods due to changes in creatinine assays over time [\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e]. Within each study, we estimated the association between AKI and in-hospital mortality with Firth logistic regression to address sparse cells and separation [\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e], adjusting for age in all studies and assay type only in studies that used\u0026thinsp;\u0026gt;\u0026thinsp;1 creatinine method. Study-specific log odds ratios (ORs) were pooled using a random-effects model with restricted maximum likelihood estimation and Hartung\u0026ndash;Knapp confidence intervals [\u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]. Heterogeneity was summarized with Cochran\u0026rsquo;s Q and I\u0026sup2;, and a prediction interval shown in forest plots. Sensitivity analysis included: (i) repeating the two-stage analysis with conventional logistic regression, (ii) repeating both approaches to low risk-of-bias studies, and (iii) a one-stage mixed-effects logistic model with a random intercept for study (fixed AKI effect) adjusting for age and assay type (when applicable).\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSubgroups.\u003c/em\u003e We fit separate mixed-effect logistic models (random intercept for study) for each subgrouping variable (age, decade, region, sex, assay method, severe wasting, severe malaria) including an AKI \u0026times; subgroup interaction. We report contrasts (the adjusted odds ratio (aOR) for AKI) within each subgroup and show the overall AKI effect as a reference line in the plots.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eSecondary exposures.\u003c/em\u003e For secondary exposures, we evaluated hyperkalemia and elevated BUN using the same subgroup framework, adjusted for age. Because between-study heterogeneity was larger for these exposures, corresponding two-stage meta-analyses are presented in Additional File 1.\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eCovariate strategy.\u003c/em\u003e We adjusted only for variables with meaningful within-study variation and a confounding role. Age was included in all models; assay type was included only in the one study with \u0026gt;\u0026thinsp;1 method. Variables that were constant within studies (e.g., region, decade, sex) or likely to be on the causal pathway (e.g., antimalarial regimen) were not included in the primary adjustment set, but were explored in sub-group analysis.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eMediation\u003c/h3\u003e\n\u003cp\u003eTo quantify the extent to which the AKI\u0026ndash;mortality association operates through hyperkalemia or elevated BUN, we used logistic mediator and outcome models that included study fixed effects and study-clustered inference. Models were adjusted for age, sex, decade, and region. If fixed effects were not estimable in sparse strata, we refit without them but retained clustering. We estimated average causal mediation effects, average direct effects, total effects, and proportion mediated using quasi-Bayesian Monte Carlo with 2,000 simulations.\u003c/p\u003e\n\u003cp\u003eAll analyses were performed using R version 4.3.2 and Stata version 18.\u003c/p\u003e\n\u003ch3\u003eData Access and Availability\u003c/h3\u003e\n\u003cp\u003eSource data can be found at the following link. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.7910/DVN/EBQNQD\u003c/span\u003e\u003c/span\u003e (Harvard Dataverse) [\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e13,528 children, aged between 3 months and 16 years, from 8 countries spanning 33 years were included in the study (Figure 1). While participant eligibility extended to 18 years, no participants older than 16 years were recruited across the studies. Most participants were from East Africa (89%) and 58% were from Kilifi, Kenya. Study characteristics are presented in Table 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAKI frequency\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess the frequency of AKI over time, data from 2008 onward were used, following the implementation of isotope dilution mass spectrometry (IDMS)-traceable assays. Overall, 3,297 children had AKI (47% [95% CI 46% to 48%]) (Figure 2) with no difference in AKI frequency over time. Of the children with AKI, 46% had KDIGO-defined Stage 1 AKI, 30% had Stage 2, and 23% had Stage 3 and 3.4% had WHO-defined renal impairment.\u003c/p\u003e\n\u003cp\u003eKDIGO-AKI frequency varied by age and was lowest in older children (under 2 years, 45%; 2-4 years, 50%; 5-9 years, 47%; 10 years or older, 38%; p\u0026lt;0.0001). When comparing KDIGO-defined AKI and WHO-defined renal impairment, 93% (3059/3297) of KDIGO-defined AKI cases were missed when using a threshold of 3mg/dL. When stratified by KDIGO-defined AKI stage, all WHO-defined AKI cases fell within Stage 3; yet the WHO definition still missed 63% of Stage 3 cases. AKI frequency using KDIGO definitions and minimum creatinine thresholds, as well as the WHO creatinine threshold, was modeled by age category and calendar time (Additional File 1, Figure S1). With increasing creatinine thresholds, the frequency of AKI declined and had the largest impact on children \u0026lt;2 years of age.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMortality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe potential association between KDIGO-defined AKI and in-hospital mortality was examined across all studies, including data collected before the implementation of IDMS-traceable assays. There were 951 deaths across all studies (7.0%). The mortality rates were 9.1% among patients with AKI and 3.5% in patients without AKI, respectively. There was a decline in malaria mortality over time, with a mortality rate of 13.1% before 2000, decreasing to 7.5% between 2000 and 2010, 5.0% between 2010 and 2020, and 4.6% after 2020. Mortality rates were consistent across all age groups and did not differ by sex (7.0% in females vs. 7.1% in males). In-hospital mortality was 8.4% and 4.8% prior to and after 2011, respectively, when artemisinin-derivatives were recommended as the first-line therapy for African children with severe malaria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociation between AKI and mortality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAKI was associated with a pooled odds ratio of in-hospital mortality of 2.87 (95% CI 2.28 to 3.61) across all studies (Figure 3), adjusting for age and assay method using a two-stage approach. There was a monotonic increase in mortality with increased AKI stages, with pooled mortality of 4.8%, 6.7% and 15% for stages 1 to 3, respectively (Table 2) compared to 3.5% in children without AKI. The results were comparable when calculating the fold change in creatinine from estimated baseline and simplified age-based thresholds (adjusted odds ratio 2.81 [95% CI 2.23, 3.54], Additional File 1, Figure S5). In a sensitivity analysis evaluating KDIGO-defined AKI on mortality, excluding all children who met the WHO definition of renal impairment, AKI remained a significant predictor of mortality with an odds ratio of 2.65 (95% CI 2.12 to 3.33; Additional File 1, \u0026nbsp;Figure S6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Mortality by AKI definition and stage\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal N\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (%) died\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKDIGO-defined AKI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eNo AKI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e4398\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e152 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e3164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e151 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.63 (1.28, 2.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e3172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e212 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e2.35 (1.86, 2.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e2794\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e436 (15.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e6.37 (5.10, 7.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOperationalized age thresholds\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eNo AKI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e5660\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e204 (3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e63 (4.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.36 (1.00, 1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e3840\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e269 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e2.15 (1.76, 2.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eStage 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e2688\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e416 (15.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e5.60 (4.59, 6.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWHO definition\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 258px;\"\u003e\n \u003cp\u003eRenal impairment (creatinine\u0026gt;3mg/dL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e272\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e47 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e5.58 (3.86, 8.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 542px;\"\u003e\n \u003cp\u003eMixed-effect logistic regression model adjusted for age and assay type\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAs a sensitivity analysis, a one-stage approach was also used, which yielded a similar adjusted odds ratio (2.87 [95% CI 2.38 to 3.46], Figure 4) adjusting for age and assay method. The relationship between AKI and mortality was maintained across all pre-specified subgroups (Figure 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSecondary outcome: dialysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 13,528 participants, 78 received acute dialysis (0.6%) in Uganda and Nigeria. Dialysis was first administered in 2014, with a gradual increase in access over time, with 4.7% of children with severe malaria receiving dialysis in 2024 to 2025. In studies where dialysis was available, 45/1640 (2.7%) received hemodialysis, while 11/1640 (0.7%) received peritoneal dialysis. Mortality was 18.0% in children who received dialysis and was higher among children who received peritoneal dialysis (54.6%) compared to hemodialysis (11.1%). Using mixed-effects logistic regression with a random intercept for study, mortality was 62% lower in settings with dialysis available (OR, 0.38; 95% CI, 0.25 to 0.59), adjusting for child age, sex, AKI, hyperkalemia, and uremia.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSecondary exposures: hyperkalemia and elevated BUN\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComplications of AKI include the accumulation of nitrogenous waste products (e.g., BUN) and electrolyte abnormalities, including hyperkalemia [34]. As secondary exposures, we evaluated the relationship between elevated BUN, hyperkalemia, and mortality. Hyperkalemia occurred in 7.6% of patients, and 29.3% of children had elevated BUN. Hyperkalemia rates were highest among children under 2 years (9%) and declined with age to 5% in children \u0026gt;10 years (p\u0026lt;0.0001), while elevated BUN was lowest in children under 2 years (19%) and increased across age groups to 45% in children \u0026gt;10 years (p\u0026lt;0.0001). There was evidence of heterogeneity across regions for both hyperkalemia and elevated BUN, with neither associated with mortality in studies from West Africa (Figure 5).\u003c/p\u003e\n\u003cp\u003eOverall, both hyperkalemia and elevated BUN were associated with mortality (pooled OR 6.04 [95% CI 5.06 to 7.21] and 2.82 [2.11 to 3.76], respectively).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe effect of AKI complications hyperkalemia and elevated BUN on mortality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMediation analysis was used to evaluate the relationship between AKI and elevated BUN or hyperkalemia on mortality. Among children with hyperkalemia, 83.2% had AKI, and among children with elevated BUN, 73.4% had AKI. In causal mediation models adjusted for age, sex, decade, and region, elevated BUN explained 21% of the association between AKI and in-hospital mortality (p=0.048). Hyperkalemia explained 18% of AKI-related mortality and did not reach statistical significance (p=0.07) (Figure 6).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis individual patient data meta-analysis of African children with \u003cem\u003ePlasmodium falciparum\u003c/em\u003e malaria included data from 13,528 children collected over 33 years across eight countries. Using the KDIGO criteria, AKI occurred in 47% of children with severe malaria and is a robust and independent predictor of mortality (OR 2.87 [95% CI 2.28 to 3.61]). Subgroup analyses indicate that the high burden of AKI was consistent across time, by age, and associated with mortality across all regions in Africa.\u003c/p\u003e\u003cp\u003eIn Africa, severe malaria cases and deaths are highest in children less than 2 years of age and are less frequent amongst older children and adults due to the acquisition of naturally acquired immunity [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. In this vulnerable population, the frequency of community-acquired AKI was 47%, with 67% of deaths occurring in the context of AKI. Previously, AKI was considered more common in older children and adults when applying a single creatinine threshold of 3mg/dL to define the disease [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, when applying age-appropriate approaches to estimate baseline creatinine, the frequency of AKI was lowest in older children. The relationship between AKI and mortality across age groups emphasizes the need for increased education and awareness of AKI in young children, where AKI occurs at low creatinine thresholds compared to older children and adults. Proposed age-based thresholds to facilitate AKI recognition by age and across AKI stages are outlined in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. These thresholds are based on simplified age-based thresholds derived from baseline creatinine estimates, rounded and grouped by age to facilitate bedside recognition of AKI. This approach had comparable performance to KDIGO-defined AKI and had minimal misclassification of severe (stage 2 or 3) AKI.\u003c/p\u003e\u003cp\u003eWhen evaluating AKI during an initial clinical encounter or in an epidemiological setting, baseline creatinine should be estimated, as most AKI in severe malaria is community-acquired[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Approaches to estimating baseline creatinine, validated in African pediatric cohorts, assume an estimated glomerular filtration rate (eGFR) of 120mL/min per 1.73m\u003csup\u003e2\u003c/sup\u003e and back-calculate creatinine using age-based equations [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. One approach to mitigate the risk of over-diagnosing AKI due to imprecision in creatinine estimates involves applying a minimum creatinine threshold to define AKI [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Thresholds of 0.5mg/dL have been recommended in high-resource settings[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] but may not be appropriate in low-resource settings where undernutrition is common. In this population, applying a minimum threshold of 0.5mg/dL results in a significant reduction in AKI frequency, particularly in children\u0026thinsp;\u0026lt;\u0026thinsp;2 years. Applying a minimum threshold of 0.4mg/dL prevents over-estimation at low creatinine values, where assay precision is a concern, but does not impact AKI detection in children\u0026thinsp;\u0026ge;\u0026thinsp;2 once GFR has reached its stable value. It is important to note that in children with low baseline creatinine values (e.g., younger children, children with undernutrition), AKI may occur even when the creatinine is within normal reported laboratory ranges, and failure to identify AKI in the early stages when it is amenable to interventions can result in the progression of the disease and the need for dialysis.\u003c/p\u003e\u003cp\u003eGiven the high frequency of AKI identified in this study, we suggest all children with severe malaria should be considered at high risk for the development of AKI, with simplified age-based thresholds for identifying AKI proposed. Clinicians caring for children with severe malaria should implement kidney-focused care by monitoring creatinine levels and urine output, avoiding nephrotoxic medications when possible, and paying careful attention to patient volume status. Fluid balance may be monitored by taking daily weights, using the first measurement as the anchor weight and the same scale for all measurements. While this approach has limitations in an intensive care setting, where children with AKI may be mechanically ventilated or require extracorporeal therapies, most severe malaria is managed on general wards, and taking daily weights should be a feasible approach to assess fluid balance and identify positive fluid balances that may denote fluid overload [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Maintaining vigilance for AKI-associated complications such as hyperkalemia, acidosis, and volume overload, and being prepared to manage them as they arise, are the cornerstones of kidney-centered care for children with malaria. The findings of differences in hyperkalemia and BUN-associated mortality in West Africa call for additional research to define the etiology of AKI-related complications across geographic contexts. However, with most participants from East Africa (89%) and 58% from Kenya, broader representation from the rest of Africa is urgently needed. Regularly dosed paracetamol for 72 hours in adults with severe falciparum malaria and severe knowlesi malaria with evidence of intravascular hemolysis showed evidence of being kidney protective in randomized controlled trials [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. The role of regular paracetamol as a kidney protective agent in children with severe falciparum malaria in Africa is the subject of ongoing clinical trials (NCT04251351, ISRCTN84974248).\u003c/p\u003e\u003cp\u003eEnhanced awareness of malaria as a risk factor for AKI should prompt enhanced screening for AKI complications and implementation of triage systems to guide resource allocation and transfer to higher-level facilities for advanced monitoring and dialysis, where available. Lower mortality rates in studies and centers where dialysis was available, even with limited availability, suggest that conservative measurement of AKI complications can reduce mortality independent of dialysis. Thus, increased awareness of AKI and education on how to recognize and manage AKI are critical to support AKI recovery, reduce mortality, and avert the need for dialysis [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. For patients with worsening kidney dysfunction, early referral for organ support with dialysis should be considered. AKI-associated mortality was significantly lower when dialysis was available, even after adjusting for time, antimalarial therapy, and other clinical complications.\u003c/p\u003e\u003cp\u003eThe overall mortality rate in children with malaria receiving dialysis was 18% \u0026mdash; lower than previous estimates of 34% in African children receiving dialysis for any cause of AKI[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u0026mdash; and consistent with reports of improved survival in severe malaria-associated AKI compared to other infectious causes of AKI [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. Hemodialysis in children is complicated by issues with vascular access, limited pediatric supplies, and risks of hemodynamic instability, making peritoneal dialysis the preferred modality for younger children. Expanded access to peritoneal dialysis using improvised materials has the potential to avert deaths [\u003cspan additionalcitationids=\"CR48\" citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Late recognition and referral may contribute to increased mortality, particularly the high mortality among children receiving peritoneal dialysis, which is often implemented as a last resort. Therefore, there is an urgent need to improve access to acute dialysis as a life-saving therapy for children with severe malaria-associated AKI, with 6 to 14% of children with severe malaria having a dialysis indication[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile deaths in children with severe malaria-associated AKI may not be directly attributable to AKI, severe malaria complications, including electrolyte abnormalities and acidosis, will be exacerbated and more challenging to manage when kidney function is compromised. Mediation analysis showed that up to 21% of AKI-associated mortality was partially mediated through elevated BUN (\u0026gt;\u0026thinsp;20mg/dL). However, it is important to note that the BUN cut-off reflects prognostic thresholds identified in children with severe malaria [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e] but is well below the threshold typically associated with uremic symptoms. In the context of severe malaria, where thrombocytopenia is common, uremia (BUN\u0026thinsp;\u0026gt;\u0026thinsp;80mg/dL) may further impact platelet function, increasing both bleeding and thrombosis risk. It can contribute to cerebral edema and raise intracranial pressure in children with neurologic findings. Additionally, uremia may increase vascular permeability, leading to pulmonary edema and respiratory failure requiring advanced respiratory support. Further, AKI was associated with hyperkalemia, and hyperkalemia was associated with mortality. Hyperkalemia is more likely to occur in patients with severe malaria due to intracellular potassium shifts from intravascular hemolysis, metabolic acidosis, and decreased potassium excretion in AKI. Emergency interventions to reduce mortality from fatal cardiac dysrhythmias include stabilizing the cardiac membrane, moving potassium intracellularly, and correcting acidosis [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In non-emergent settings, loop diuretics can be used to increase potassium excretion in the urine, and cation exchange resins can increase bowel losses of potassium [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Overall, early recognition of AKI and its complications offers opportunities for clinical interventions to prevent AKI progression, avert the need for dialysis, and reduce AKI-related mortality.\u003c/p\u003e\u003cp\u003eThis individual patient-level meta-analysis included a large sample size encompassing severe malaria hospitalizations over 33 years and representation from across Africa, demonstrating that AKI is a clear and consistent risk factor for mortality. We used a single creatinine measurement at enrollment to increase the number of eligible studies. The results remained consistent over time, independent of variations in creatinine assay methodology. While some studies had a moderate risk of bias, predominantly due to the selection of children with certain features of severe malaria (e.g., coma, dark urine), the findings were consistent across studies. Data largely reflect findings from East Africa, where malaria transmission is stable. We lack comprehensive data from Western Africa, a region characterized by seasonal malaria transmission, where a relatively high incidence of kidney risk variants (e.g., \u003cem\u003eAPOL1\u003c/em\u003e), which may influence susceptibility to AKI and affect kidney recovery [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOverall, mortality is estimated at 7% among children hospitalized with severe malaria. Assuming 597,000 malaria deaths annually, we estimate there are over 8\u0026nbsp;million severe malaria cases each year. AKI occurs in roughly 40% of children and adults with severe malaria, which equates to more than 3\u0026nbsp;million AKI cases attributable to malaria every year. Although the International Society of Nephrology aims to eliminate preventable deaths from AKI by 2025 [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e], we remain far from achieving this goal. Severe malaria-associated AKI is a preventable cause of death, and public health efforts to prevent infection through vector control programs, vaccination, and early and effective treatment of infection can avert substantial morbidity and mortality.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEach participating study obtained written informed consent from an institutional review board as outlined in Additional File 2 under the methods for each study. De-identified participant level data were provided for the meta-analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available in the Harvard Dataverse. https://doi.org/10.7910/DVN/EBQNQD.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study is funded by a National Institutes of Health project grant (R01 AI165946) through the National Institute of Allergy and Infectious Diseases (NIAID) to ALC. The Fogarty International Center of the National Institutes of Health supports this study under Award Number K43TW012586 to AB.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAB, MTH, RN, NA, NOB, PI, JS, J, JB, PH, HW, ROO, LPO, RHRE, FA, OI, QB, KCK, CCJ, ALC conducted initial study recruitment and contributed source data. CB, AB CL, ALC contributed to data extraction and cleaning. CB, ALC, YZ contributed to the statistical analysis. ALC and CB drafted the manuscript with input from all authors. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all the study teams for their participation and collection of data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors under the MaKID consortium: Caitlin Bond, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Adebowale D Ademola, College of Medicine, University of Ibadan \u0026amp; University College Hospital, Ibadan, Nigeria; Adanze O Asinobi, College of Medicine, University of Ibadan \u0026amp; University College Hospital, Ibadan, Nigeria; Folake Afolayan, Department of Pediatrics, Upstate Medical University, Syracuse, NY, USA; Nicholas Anstey, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Anthony Batte, Child Health and Development Centre, Makerere University College of Health Sciences, Kampala, Uganda; ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Quique Bassat, ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Philip Bejon, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Deo Benyumiza, Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; James A. Berkley, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Erica Bjornstaad MD, Division of Nephrology, Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA; Andrea L. Conroy, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Global Health Uganda, Kampala, Uganda; Valerie M. Crowley, Toronto General Research Institute, University Health Network - Toronto General Hospital, Toronto, ON, Canada; Jessica Dalsuco MD, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Gavin Dreyer, Department of Nephrology, Barts Health NHS Trust, London, UK; Allison A Eddy, Department of Pediatrics, University of British Columbia, and BC Children's Hospital Research Institute, Vancouver, BC, Canada; Rhys D. R. Evans, Center for Kidney Health, University College London, London, UK; Stuart L. Goldstein, Division of Nephrology, Department of Pediatrics, Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Joseph Ogavu Gyagenda, Department of Medicine St Francis Hospital Nsambya, Kampala, Uganda; Michael T. Hawkes, Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada; Rasha Hussein, Soba University Hospital, Department of Pediatric Nephrology, Khartoum, Sudan; \u0026nbsp;Olayinka Ibrahim, Department of Pediatrics, Division of Clinical Medicine, University of Global Health Equity, Kigali, Rwanda; Richard Idro, Global Health Uganda, Kampala, Uganda; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda; \u0026nbsp;Peace Imani, Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA; Chandy C. John, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Kevin C. Kain, Department of Medicine, University Health Network-Toronto General Hospital, University of Toronto, Toronto, Canada; Adeyemi Labaeka, Department of Paediatrics, University College Hospital, Ibadan, Nigeria; Claire Liepmann, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Michael Lintner-Rivera, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN, USA; Kevin Marsh, Nuffield Department of Medicine, University of Oxford, Oxford, UK; KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Mignon McCulloch, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Esther D Mwaikambo, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania; Shebe Mohammed, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Neema Mturi, KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya; Ruth Namazzi, Global Health Uganda, Kampala, Uganda; Department of Paediatrics, Makerere University College of Health Sciences, Kampala, Uganda; Moses Ngari, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Nicole O’Brien, Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA; Babatunde O Ogunbosi, Department of Paediatrics, College of Medicine, University of Ibadan \u0026amp; University College Hospital, Ibadan; Regina E Oladokun, Department of Paediatrics, College of Medicine, University of Ibadan \u0026amp; University College Hospital, Ibadan, Nigeria; Lere P Oluwadare, Department of Paediatrics, University College Hospital, Ibadan, Nigeria; Robert O. Opoka, Aga Khan University Medical College Africa, Nairobi, Kenya; Jie Ren, Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, USA; Chelsea E. Sanyu, Faculty of Medicine, Busitema University, Mbale, Uganda; Karl B. Seydel, Department of Osteopathic Medical Specialties, Michigan State University, East Lansing, Michigan; Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi; Cara Slagle, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA; Danielle E. Soranno, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA; Jonathan Sserunkuuma, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Derby Tembo, Chipata Central Hospital, Department of Pediatrics and Child Health, Chipata, Zambia; Rosauro Varo MD, Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; ISGlobal, Barcelona, Spain, Facultat de Medicina i Ciències de la Salut, Unviersitat de Barcelona (UB), Barcelona, Spain; Hunter Wynkoop, Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWHO: \u003cstrong\u003eWorld malaria report 2024: addressing inequity in the global malaria response\u003c/strong\u003e. In\u003cem\u003e.\u003c/em\u003e Edited by World Health Organization. Geneva; 2024.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization: \u003cstrong\u003eSevere malaria\u003c/strong\u003e. \u003cem\u003eTrop Med Int Health \u003c/em\u003e2014, \u003cstrong\u003e19 Suppl 1\u003c/strong\u003e:7-131.\u003c/li\u003e\n\u003cli\u003eKellum JA, Romagnani P, Ashuntantang G, Ronco C, Zarbock A, Anders HJ: \u003cstrong\u003eAcute kidney injury\u003c/strong\u003e. \u003cem\u003eNat Rev Dis Primers \u003c/em\u003e2021, \u003cstrong\u003e7\u003c/strong\u003e(1):52.\u003c/li\u003e\n\u003cli\u003eMeena J, Mathew G, Kumar J, Chanchlani R: \u003cstrong\u003eIncidence of Acute Kidney Injury in Hospitalized Children: A Meta-analysis\u003c/strong\u003e. \u003cem\u003ePediatrics \u003c/em\u003e2023, \u003cstrong\u003e151\u003c/strong\u003e(2).\u003c/li\u003e\n\u003cli\u003eSusantitaphong P, Cruz DN, Cerda J, Abulfaraj M, Alqahtani F, Koulouridis I, Jaber BL, Acute Kidney Injury Advisory Group of the American Society of N: \u003cstrong\u003eWorld incidence of AKI: a meta-analysis\u003c/strong\u003e. \u003cem\u003eClin J Am Soc Nephrol \u003c/em\u003e2013, \u003cstrong\u003e8\u003c/strong\u003e(9):1482-1493.\u003c/li\u003e\n\u003cli\u003eMwaba C, Munsaka S, Bvulani B, Mwakazanga D, Chiluba BC, Fitzwanga K, Mpabalwani E: \u003cstrong\u003eMalaria is the leading cause of acute kidney injury among a Zambian paediatric renal service cohort retrospectively evaluated for aetiologies, predictors of the need for dialysis, and outcomes\u003c/strong\u003e. \u003cem\u003ePLoS One \u003c/em\u003e2023, \u003cstrong\u003e18\u003c/strong\u003e(10):e0293037.\u003c/li\u003e\n\u003cli\u003eKher V, Srisawat N, Noiri E, Gharbi MB, Shetty MS, Yang L, Bagga A, Chakravarthi R, Mehta R, Group C: \u003cstrong\u003ePrevention and therapy of acute kidney injury in the developing world\u003c/strong\u003e. \u003cem\u003eKidney Int Rep \u003c/em\u003e2017, \u003cstrong\u003e2\u003c/strong\u003e(4):544-558.\u003c/li\u003e\n\u003cli\u003eBatte A, Luyckx VA, Taylor TE, Conroy AL: \u003cstrong\u003eMalaria guidelines fall short in diagnosing acute kidney injury\u003c/strong\u003e. \u003cem\u003eLancet Glob Health \u003c/em\u003e2024, \u003cstrong\u003e12\u003c/strong\u003e(2):e194-e196.\u003c/li\u003e\n\u003cli\u003eKDIGO: \u003cstrong\u003eNotice\u003c/strong\u003e. \u003cem\u003eKidney Int Suppl (2011) \u003c/em\u003e2012, \u003cstrong\u003e2\u003c/strong\u003e(1):1-138.\u003c/li\u003e\n\u003cli\u003eStewart LA, Clarke M, Rovers M, Riley RD, Simmonds M, Stewart G, Tierney JF, Group ftP-ID: \u003cstrong\u003ePreferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data: The PRISMA-IPD Statement\u003c/strong\u003e. \u003cem\u003eJAMA \u003c/em\u003e2015, \u003cstrong\u003e313\u003c/strong\u003e(16):1657-1665.\u003c/li\u003e\n\u003cli\u003eKellum JA, Lameire N, Aspelin P: \u003cstrong\u003eKidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury\u003c/strong\u003e. \u003cem\u003eKidney Int Suppl \u003c/em\u003e2012, \u003cstrong\u003e2\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eWells GA, Shea B, O\u0026rsquo;Connell D, Peterson J, Welch V, Losos M, Tugwell P: \u003cstrong\u003eThe Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses\u003c/strong\u003e. In\u003cem\u003e.\u003c/em\u003e: Oxford; 2000.\u003c/li\u003e\n\u003cli\u003eAnstey NM, Weinberg JB, Hassanali MY, Mwaikambo ED, Manyenga D, Misukonis MA, Arnelle DR, Hollis D, McDonald MI, Granger DL: \u003cstrong\u003eNitric oxide in Tanzanian children with malaria: inverse relationship between malaria severity and nitric oxide production/nitric oxide synthase type 2 expression\u003c/strong\u003e. \u003cem\u003eJ Exp Med \u003c/em\u003e1996, \u003cstrong\u003e184\u003c/strong\u003e(2):557-567.\u003c/li\u003e\n\u003cli\u003eEvans RD, Hemmila U, Craik A, Mtekateka M, Hamilton F, Kawale Z, Kirwan CJ, Dobbie H, Dreyer G: \u003cstrong\u003eIncidence, aetiology and outcome of community-acquired acute kidney injury in medical admissions in Malawi\u003c/strong\u003e. \u003cem\u003eBMC Nephrol \u003c/em\u003e2017, \u003cstrong\u003e18\u003c/strong\u003e(1):21.\u003c/li\u003e\n\u003cli\u003eConroy AL, Hawkes M, Elphinstone RE, Morgan C, Hermann L, Barker KR, Namasopo S, Opoka RO, John CC, Liles WC\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAcute Kidney Injury Is Common in Pediatric Severe Malaria and Is Associated With Increased Mortality\u003c/strong\u003e. \u003cem\u003eOpen Forum Infect Dis \u003c/em\u003e2016, \u003cstrong\u003e3\u003c/strong\u003e(2):ofw046.\u003c/li\u003e\n\u003cli\u003eConroy AL, Opoka RO, Bangirana P, Idro R, Ssenkusu JM, Datta D, Hodges JS, Morgan C, John CC: \u003cstrong\u003eAcute kidney injury is associated with impaired cognition and chronic kidney disease in a prospective cohort of children with severe malaria\u003c/strong\u003e. \u003cem\u003eBMC Med \u003c/em\u003e2019, \u003cstrong\u003e17\u003c/strong\u003e(1):98.\u003c/li\u003e\n\u003cli\u003eHawkes MT, Leligdowicz A, Batte A, Situma G, Zhong K, Namasopo S, Opoka RO, Kain KC, Conroy AL: \u003cstrong\u003ePathophysiology of Acute Kidney Injury in Malaria and Non-Malarial Febrile Illness: A Prospective Cohort Study\u003c/strong\u003e. \u003cem\u003ePathogens \u003c/em\u003e2022, \u003cstrong\u003e11\u003c/strong\u003e(4).\u003c/li\u003e\n\u003cli\u003eNamazzi R, Batte A, Opoka RO, Bangirana P, Schwaderer AL, Berrens Z, Datta D, Goings M, Ssenkusu JM, Goldstein SL\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAcute kidney injury, persistent kidney disease, and post-discharge morbidity and mortality in severe malaria in children: A prospective cohort study\u003c/strong\u003e. \u003cem\u003eEClinicalMedicine \u003c/em\u003e2022, \u003cstrong\u003e44\u003c/strong\u003e:101292.\u003c/li\u003e\n\u003cli\u003eTembo D, Mwanza S, Mwaba C, Dallah I, wa Somwe S, Seydel KB, Birbeck GL: \u003cstrong\u003eRisk factors for acute kidney injury at presentation among children with CNS malaria: a case control study\u003c/strong\u003e. \u003cem\u003eMalaria journal \u003c/em\u003e2022, \u003cstrong\u003e21\u003c/strong\u003e(1):310.\u003c/li\u003e\n\u003cli\u003eVaro R, Crowley VM, Mucasse H, Sitoe A, Bramugy J, Serghides L, Weckman AM, Erice C, Bila R, Vitorino P\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAdjunctive rosiglitazone treatment for severe paediatric malaria: a randomized placebo-controlled trial in Mozambican children\u003c/strong\u003e. \u003cem\u003eInt J Infect Dis \u003c/em\u003e2023.\u003c/li\u003e\n\u003cli\u003eBatte A, Nakulima V, Namazzi R, Aujo JC, Starr MC, Schwaderer AL, Lintner-Rivera M, Ahumwire A, Ogwal D, Tenywa E\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eMalaria associated pathogenesis of chronic kidney disease (MAP-CKD): a prospective study of children hospitalized with severe malaria\u003c/strong\u003e. \u003cem\u003eBMC Nephrology \u003c/em\u003e2025, \u003cstrong\u003e26\u003c/strong\u003e(1):390.\u003c/li\u003e\n\u003cli\u003ePottel H, Hoste L, Martens F: \u003cstrong\u003eA simple height-independent equation for estimating glomerular filtration rate in children\u003c/strong\u003e. \u003cem\u003ePediatr Nephrol \u003c/em\u003e2012, \u003cstrong\u003e27\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eNjuguna P, Maitland K, Nyaguara A, Mwanga D, Mogeni P, Mturi N, Mohammed S, Mwambingu G, Ngetsa C, Awuondo K\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eObservational study: 27 years of severe malaria surveillance in Kilifi, Kenya\u003c/strong\u003e. \u003cem\u003eBMC Med \u003c/em\u003e2019, \u003cstrong\u003e17\u003c/strong\u003e(1):124.\u003c/li\u003e\n\u003cli\u003eFirth D: \u003cstrong\u003eBias reduction of maximum likelihood estimates\u003c/strong\u003e. \u003cem\u003eBiometrika \u003c/em\u003e1993, \u003cstrong\u003e80\u003c/strong\u003e(1):27-38.\u003c/li\u003e\n\u003cli\u003eHartung J, Knapp G: \u003cstrong\u003eA refined method for the meta-analysis of controlled clinical trials with binary outcome\u003c/strong\u003e. \u003cem\u003eStat Med \u003c/em\u003e2001, \u003cstrong\u003e20\u003c/strong\u003e(24):3875-3889.\u003c/li\u003e\n\u003cli\u003eConroy A: \u003cstrong\u003eReplication Data for: Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis\u003c/strong\u003e. In\u003cem\u003e.\u003c/em\u003e, DRAFT VERSION edn: Harvard Dataverse; 2025.\u003c/li\u003e\n\u003cli\u003eImani PD, Odiit A, Hingorani SR, Weiss NS, Eddy AA: \u003cstrong\u003eAcute kidney injury and its association with in-hospital mortality among children with acute infections\u003c/strong\u003e. \u003cem\u003ePediatr Nephrol \u003c/em\u003e2013, \u003cstrong\u003e28\u003c/strong\u003e(11):2199-2206.\u003c/li\u003e\n\u003cli\u003eNamazzi R, Opoka R, Datta D, Bangirana P, Batte A, Berrens Z, Goings MJ, Schwaderer AL, Conroy AL, John CC: \u003cstrong\u003eAcute Kidney Injury Interacts With Coma, Acidosis, and Impaired Perfusion to Significantly Increase Risk of Death in Children With Severe Malaria\u003c/strong\u003e. \u003cem\u003eClin Infect Dis \u003c/em\u003e2022, \u003cstrong\u003e75\u003c/strong\u003e(9):1511-1519.\u003c/li\u003e\n\u003cli\u003eConradi N, Opoka RO, Mian Q, Conroy AL, Hermann LL, Charles O, Amone J, Nabwire J, Lee BE, Saleh A\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eSolar-powered O(2) delivery for the treatment of children with hypoxaemia in Uganda: a stepped-wedge, cluster randomised controlled trial\u003c/strong\u003e. \u003cem\u003eLancet \u003c/em\u003e2024, \u003cstrong\u003e403\u003c/strong\u003e(10428):756-765.\u003c/li\u003e\n\u003cli\u003eNakuya M, Batte A, Musiime V: \u003cstrong\u003ePrevalence and factors associated with Acute Kidney Injury among children aged 6month- 12years passing dark urine admitted at Soroti Regional Referral Hospital: A cross-sectional study\u003c/strong\u003e. \u003cem\u003eRes Sq \u003c/em\u003e2023.\u003c/li\u003e\n\u003cli\u003eAfolayan FM, Adedoyin OT, Abdulkadir MB, Ibrahim OR, Biliaminu SA, Mokuolu OA, Ojuawo A: \u003cstrong\u003eAcute Kidney Injuries in Children with Severe Malaria: A comparative study of diagnostic criteria based on serum cystatin C and creatinine levels\u003c/strong\u003e. \u003cem\u003eSultan Qaboos Univ Med J \u003c/em\u003e2020, \u003cstrong\u003e20\u003c/strong\u003e(4):e312-e317.\u003c/li\u003e\n\u003cli\u003eIbrahim OR, Afolayan FM, Alao MA, Mohammed B, Suleiman BM, Adedoyin OT: \u003cstrong\u003eImpact of methods of estimating baseline Serum Creatinine (bSCr) on the incidence and outcomes of acute kidney injury in childhood severe malaria\u003c/strong\u003e. \u003cem\u003eEgyptian Pediatric Association Gazette \u003c/em\u003e2023, \u003cstrong\u003e71\u003c/strong\u003e(1):36.\u003c/li\u003e\n\u003cli\u003eOluwadare LP, Oladokun RE, Ogunbosi BO, Labaeka AA, Taiwo OJ: \u003cstrong\u003eClinical Epidemiology and Geospatial Distribution of Cases of Severe Malaria in Children at a Tertiary Care Health Facility in Southwest Nigeria\u003c/strong\u003e. \u003cem\u003eInternational Journal of Medicine and Health Development \u003c/em\u003e2025, \u003cstrong\u003e30\u003c/strong\u003e(2).\u003c/li\u003e\n\u003cli\u003eLintner-Rivera M, Bhutta A, Namazzi R, Bond C, Conroy AL, Batte A: \u003cstrong\u003eHyperkalemia in Pediatric Severe Malaria\u003c/strong\u003e. \u003cem\u003eSemin Nephrol \u003c/em\u003e2025, \u003cstrong\u003e45\u003c/strong\u003e(3):151620.\u003c/li\u003e\n\u003cli\u003eCarneiro I, Roca-Feltrer A, Griffin JT, Smith L, Tanner M, Schellenberg JA, Greenwood B, Schellenberg D: \u003cstrong\u003eAge-patterns of malaria vary with severity, transmission intensity and seasonality in sub-Saharan Africa: a systematic review and pooled analysis\u003c/strong\u003e. \u003cem\u003ePLoS One \u003c/em\u003e2010, \u003cstrong\u003e5\u003c/strong\u003e(2):e8988.\u003c/li\u003e\n\u003cli\u003eAbdullah S, Adazu K, Masanja H, Diallo D, Hodgson A, Ilboudo-Sanogo E, Nhacolo A, Owusu-Agyei S, Thompson R, Smith T\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003ePatterns of Age-Specific Mortality in Children in Endemic Areas of Sub-Saharan Africa\u003c/strong\u003e. \u003cem\u003eThe American Journal of Tropical Medicine and Hygiene \u003c/em\u003e2007, \u003cstrong\u003e77\u003c/strong\u003e(6_Suppl):99-105.\u003c/li\u003e\n\u003cli\u003eBatte A, Berrens Z, Murphy K, Mufumba I, Sarangam ML, Hawkes MT, Conroy AL: \u003cstrong\u003eMalaria-Associated Acute Kidney Injury in African Children: Prevalence, Pathophysiology, Impact, and Management Challenges\u003c/strong\u003e. \u003cem\u003eInt J Nephrol Renovasc Dis \u003c/em\u003e2021, \u003cstrong\u003e14\u003c/strong\u003e:235-253.\u003c/li\u003e\n\u003cli\u003eBatte A, Starr MC, Schwaderer AL, Opoka RO, Namazzi R, Phelps Nishiguchi ES, Ssenkusu JM, John CC, Conroy AL: \u003cstrong\u003eMethods to estimate baseline creatinine and define acute kidney injury in lean Ugandan children with severe malaria: a prospective cohort study\u003c/strong\u003e. \u003cem\u003eBMC Nephrol \u003c/em\u003e2020, \u003cstrong\u003e21\u003c/strong\u003e(1):417.\u003c/li\u003e\n\u003cli\u003eSelewski DT, Cornell TT, Heung M, Troost JP, Ehrmann BJ, Lombel RM, Blatt NB, Luckritz K, Hieber S, Gajarski R\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eValidation of the KDIGO acute kidney injury criteria in a pediatric critical care population\u003c/strong\u003e. \u003cem\u003eIntensive Care Medicine \u003c/em\u003e2014, \u003cstrong\u003e40\u003c/strong\u003e(10):1481-1488.\u003c/li\u003e\n\u003cli\u003eKuai Y, Li M, Chen J, Jiang Z, Bai Z, Huang H, Wei L, Liu N, Li X, Lu G\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eComparison of diagnostic criteria for acute kidney injury in critically ill children: a multicenter cohort study\u003c/strong\u003e. \u003cem\u003eCrit Care \u003c/em\u003e2022, \u003cstrong\u003e26\u003c/strong\u003e(1):207.\u003c/li\u003e\n\u003cli\u003eSelewski DT, Barhight MF, Bjornstad EC, Ricci Z, de Sousa Tavares M, Akcan-Arikan A, Goldstein SL, Basu R, Bagshaw SM: \u003cstrong\u003eFluid assessment, fluid balance, and fluid overload in sick children: a report from the Pediatric Acute Disease Quality Initiative (ADQI) conference\u003c/strong\u003e. \u003cem\u003ePediatr Nephrol \u003c/em\u003e2023.\u003c/li\u003e\n\u003cli\u003eCooper DJ, Grigg MJ, Plewes K, Rajahram GS, Piera KA, William T, Menon J, Koleth G, Edstein MD, Birrell GW\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eThe Effect of Regularly Dosed Acetaminophen vs No Acetaminophen on Renal Function in Plasmodium knowlesi Malaria (PACKNOW): A Randomized, Controlled Trial\u003c/strong\u003e. \u003cem\u003eClin Infect Dis \u003c/em\u003e2022, \u003cstrong\u003e75\u003c/strong\u003e(8):1379-1388.\u003c/li\u003e\n\u003cli\u003ePlewes K, Kingston HWF, Ghose A, Wattanakul T, Hassan MMU, Haider MS, Dutta PK, Islam MA, Alam S, Jahangir SM\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAcetaminophen as a Renoprotective Adjunctive Treatment in Patients With Severe and Moderately Severe Falciparum Malaria: A Randomized, Controlled, Open-Label Trial\u003c/strong\u003e. \u003cem\u003eClin Infect Dis \u003c/em\u003e2018, \u003cstrong\u003e67\u003c/strong\u003e(7):991-999.\u003c/li\u003e\n\u003cli\u003eMottes T, Menon S, Conroy A, Jetton J, Dolan K, Arikan AA, Basu RK, Goldstein SL, Symons JM, Alobaidi R\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003ePediatric AKI in the real world: changing outcomes through education and advocacy-a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference\u003c/strong\u003e. \u003cem\u003ePediatr Nephrol \u003c/em\u003e2023.\u003c/li\u003e\n\u003cli\u003eOlowu WA, Niang A, Osafo C, Ashuntantang G, Arogundade FA, Porter J, Naicker S, Luyckx VA: \u003cstrong\u003eOutcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review\u003c/strong\u003e. \u003cem\u003eLancet Glob Health \u003c/em\u003e2016, \u003cstrong\u003e4\u003c/strong\u003e(4):e242-250.\u003c/li\u003e\n\u003cli\u003eAdemola AD, Asinobi AO, Alao MA, Wade AW: \u003cstrong\u003ePaediatric Dialysis at a Tertiary Hospital in South-West Nigeria: A 4-Year Report\u003c/strong\u003e. \u003cem\u003eBlood Purif \u003c/em\u003e2022, \u003cstrong\u003e51\u003c/strong\u003e(12):1015-1021.\u003c/li\u003e\n\u003cli\u003eNourse P, Cullis B, Finkelstein F, Numanoglu A, Warady B, Antwi S, McCulloch M: \u003cstrong\u003eISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 Update (paediatrics)\u003c/strong\u003e. \u003cem\u003ePerit Dial Int \u003c/em\u003e2021, \u003cstrong\u003e41\u003c/strong\u003e(2):139-157.\u003c/li\u003e\n\u003cli\u003eNkoy AB, Ndiyo YM, Matoka TT, Odio BM, Kazadi OK, Aloni MN, Collard L, McCulloch M, Ngiyulu RM, Gini JE\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eA promising pediatric peritoneal dialysis experience in a resource-limited setting with the support of saving young lives program\u003c/strong\u003e. \u003cem\u003ePerit Dial Int \u003c/em\u003e2020, \u003cstrong\u003e40\u003c/strong\u003e(5):504-508.\u003c/li\u003e\n\u003cli\u003eMcCulloch MI, Nourse P, Argent AC: \u003cstrong\u003eUse of locally prepared peritoneal dialysis (PD) fluid for acute PD in children and infants in Africa\u003c/strong\u003e. \u003cem\u003ePerit Dial Int \u003c/em\u003e2020, \u003cstrong\u003e40\u003c/strong\u003e(5):441-445.\u003c/li\u003e\n\u003cli\u003evon Seidlein L, Olaosebikan R, Hendriksen IC, Lee SJ, Adedoyin OT, Agbenyega T, Nguah SB, Bojang K, Deen JL, Evans J\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003ePredicting the clinical outcome of severe falciparum malaria in african children: findings from a large randomized trial\u003c/strong\u003e. \u003cem\u003eClin Infect Dis \u003c/em\u003e2012, \u003cstrong\u003e54\u003c/strong\u003e(8):1080-1090.\u003c/li\u003e\n\u003cli\u003eHung AM, Shah SC, Bick AG, Yu Z, Chen HC, Hunt CM, Wendt F, Wilson O, Greevy RA, Chung CP\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAPOL1 Risk Variants, Acute Kidney Injury, and Death in Participants With African Ancestry Hospitalized With COVID-19 From the Million Veteran Program\u003c/strong\u003e. \u003cem\u003eJAMA Intern Med \u003c/em\u003e2022, \u003cstrong\u003e182\u003c/strong\u003e(4):386-395.\u003c/li\u003e\n\u003cli\u003eGbadegesin RA, Ulasi I, Ajayi S, Raji Y, Olanrewaju T, Osafo C, Ademola AD, Asinobi A, Winkler CA, Burke D\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAPOL1 Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans\u003c/strong\u003e. \u003cem\u003eN Engl J Med \u003c/em\u003e2024, \u003cstrong\u003e0\u003c/strong\u003e(0).\u003c/li\u003e\n\u003cli\u003eMehta RL, Cerda J, Burdmann EA, Tonelli M, Garcia-Garcia G, Jha V, Susantitaphong P, Rocco M, Vanholder R, Sever MS\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eInternational Society of Nephrology\u0026apos;s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology\u003c/strong\u003e. \u003cem\u003eLancet \u003c/em\u003e2015, \u003cstrong\u003e385\u003c/strong\u003e(9987):2616-2643.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 2 is available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"acute kidney injury, severe malaria, mortality, KDIGO, meta-analysis, Africa","lastPublishedDoi":"10.21203/rs.3.rs-8106913/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8106913/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground.\u003c/h2\u003e\u003cp\u003eHistorically, 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.\u003c/p\u003e\u003ch2\u003eMethods.\u003c/h2\u003e\u003cp\u003eStudies 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 severe \u003cem\u003ePlasmodium falciparum\u003c/em\u003e 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.\u003c/p\u003e\u003ch2\u003eResults.\u003c/h2\u003e\u003cp\u003eWe 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 46% 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\u0026thinsp;\u0026gt;\u0026thinsp;3mg/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.\u003c/p\u003e\u003ch2\u003eDiscussion.\u003c/h2\u003e\u003cp\u003eAKI was strongly associated with mortality in African children with severe 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.\u003c/p\u003e\u003ch2\u003eOther.\u003c/h2\u003e\u003cp\u003eFunded by National Institutes of Health (1R01AI165946), registered number PROSPERO (CRD42024560012).\u003c/p\u003e","manuscriptTitle":"Identification of acute kidney injury in African children with severe malaria: a multinational individual participant data meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-23 15:50:53","doi":"10.21203/rs.3.rs-8106913/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-05T04:10:32+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-15T20:34:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T16:10:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-10T21:18:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"19351152005142048552411792086280589260","date":"2026-04-05T06:40:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310413684962749026716589799471362386521","date":"2026-04-01T22:40:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"309594538394556203288916675033154368028","date":"2026-04-01T08:08:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92631855873551293849161046209723004723","date":"2026-03-30T08:47:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-23T21:29:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-15T13:30:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"336665481662139424788118023553557462987","date":"2026-02-05T16:06:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236586626746781482713333272637505324839","date":"2026-01-25T10:29:24+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-08T17:19:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-14T04:15:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-14T04:11:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medicine","date":"2025-11-13T14:41:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmed","sideBox":"Learn more about [BMC Medicine](http://bmcmedicine.biomedcentral.com/)","snPcode":"12916","submissionUrl":"https://submission.nature.com/new-submission/12916/3","title":"BMC Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"81567d47-4350-4438-83bf-c68250cecb73","owner":[],"postedDate":"November 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T04:24:20+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-23 15:50:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8106913","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8106913","identity":"rs-8106913","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}