Evidence map›Paper›PMID 35349633›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Acute Kidney Injury Interacts With Coma, Acidosis, and Impaired Perfusion to Significantly Increase Risk of Death in Children With Severe Malaria.

Ruth Namazzi, Robert Opoka, Dibyadyuti Datta, Paul Bangirana, Anthony Batte, Zachary Berrens, Michael J Goings, Andrew L Schwaderer, Andrea L Conroy, Chandy C John

Open access · greenAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
10.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 42 citations in OpenAlex.

  1. Cerebral Malaria and Severe Malarial Anemia, but not Other Forms of Severe Malaria, Are Associated With Long-Term Cognitive Impairment.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Multiple Organ Dysfunction Syndrome in Malawian Children with Cerebral Malaria.The American journal of tropical medicine and hygiene · 2024
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Post-Discharge Mortality in Recently Hospitalized African Children: A Hidden Crisis.The American journal of tropical medicine and hygiene · 2023
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Ruth NamazziDepartment of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
Robert OpokaDepartment of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
Dibyadyuti DattaDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Paul BangiranaGlobal Health Uganda, Kampala, Uganda.
Anthony BatteChild Development Centre, Makerere University, Kampala, Uganda.
Zachary BerrensDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Michael J GoingsIndiana University Center for Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Andrew L SchwadererDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Andrea L ConroyDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-5328-6511
Chandy C JohnDepartment of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Center for Global Health · USIndiana University School of MedicineWorld Health Organization - Uganda · UGMakerere University · UG

Funding

Severe Malaria And Risk to The Brain (SMART Brain)R01NS055349 · NINDS · UNIVERSITY OF MINNESOTA · PI Chandy C. John, Ruth Namazzi · 2008 to 2026
$11.2M
Research training in infection, nutrition and neurodevelopment in UgandaD43TW010928 · FIC · INDIANA UNIVERSITY INDIANAPOLIS · PI Chandy C. John · 2018 to 2026
$1.9M
Research Training in Infection and Neurodevelopment in UgandaD43NS078280 · NINDS · UNIVERSITY OF MINNESOTA · PI JOHN, CHANDY C. · 2011 to 2015
$1.1M
FIC NIH HHS D43 TW010928NINDS NIH HHS D43 NS078280NINDS NIH HHS R01 NS055349
6 · The paper itself

Abstract

backgroundMortality in severe malaria remains high in children treated with intravenous artesunate. Acute kidney injury (AKI) is a common complication of severe malaria, but the interactions between AKI and other complications on the risk of mortality in severe malaria are not well characterized.

methodsBetween 2014 and 2017, 600 children aged 6-48 months to 4 years hospitalized with severe malaria were enrolled in a prospective clinical cohort study evaluating clinical predictors of mortality in children with severe malaria.

resultsThe mean age of children in this cohort was 2.1 years (standard deviation, 0.9 years) and 338 children (56.3%) were male. Mortality was 7.3%, and 52.3% of deaths occurred within 12 hours of admission. Coma, acidosis, impaired perfusion, AKI, elevated blood urea nitrogen (BUN), and hyperkalemia were associated with increased mortality (all P < .001). AKI interacted with each risk factor to increase mortality (P < .001 for interaction). Children with clinical indications for dialysis (14.4% of all children) had an increased risk of death compared with those with no indications for dialysis (odds ratio, 6.56; 95% confidence interval, 3.41-12.59).

conclusionsAKI interacts with coma, acidosis, or impaired perfusion to significantly increase the risk of death in severe malaria. Among children with AKI, those who have hyperkalemia or elevated BUN have a higher risk of death. A better understanding of the causes of these complications of severe malaria, and development and implementation of measures to prevent and treat them, such as dialysis, are needed to reduce mortality in severe malaria.

Indexed as

AcidosisAcute Kidney InjuryHyperkalemiaMalariaChildChild, PreschoolCohort StudiesComaFemaleHumansMalePerfusionProspective StudiesRisk Factorsacidosisacute kidney injurycomamortalitypredictorsSevere malaria

Identifiers

PMID35349633
PMCPMC9617576
OpenAlexW4220912549

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.