Open forum infectious diseases · 2026
Predictors of Acute Kidney Injury and In-Hospital Mortality in Patients With RT-PCR Confirmed Lassa Fever in Southwest Nigeria.
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Ojo Olalekan E, Hassan Muzamil O, Ojo Olubukola A, Subulade Adetumi A, Ihinmikaye Isaac, Oyegunle Oyebimpe O, Gbenga-Ayeni Olufunke B, Ayodeji Olufemi A, Ahmed Liasu A, Arogundade Fatiu A, Balogun Rasheed A
Аннотация
BACKGROUND: Data on the epidemiology of acute kidney injury (AKI) in adults hospitalized with Lassa fever is limited. We investigated the rates and predictors of AKI and in-hospital mortality at a National Treatment Centre in Southwest Nigeria.
METHODS: This retrospective study included 482 adults with RT-PCR-confirmed Lassa fever admitted to the Federal Medical Centre, Owo, Ondo State, Nigeria, from January 2019 to December 2024. Predictors of AKI and in-hospital mortality were identified by multivariable logistic regression and Cox proportional hazards regression analyses.
RESULTS: Acute kidney injury prevalence was 21% (95% CI, 17.4%-24.9%). Overall, 48 patients (10.1%) died: 33 (32.7%) with AKI and 15 (4.0%) without AKI (OR 11.647; 95% CI, 6.001-22.604; P < .001). Independent predictors of AKI included male sex (P < .001), bleeding abnormalities (P = .044), diabetes (P = .029), elevated white blood cell count (P = .005), increased neutrophil count (P = .003), and elevated aspartate transaminase (P = .017). Predictors of in-hospital mortality were AKI (P = .033), oliguria (P = .045), mean arterial blood pressure (P = .001), hematuria (P = .015), and elevated monocyte count (P = .022). Kaplan-Meier analysis demonstrated significantly poorer survival in patients with AKI versus those without (mean survival 19.0 vs 29.7 days; P ≤ .001).
CONCLUSIONS: Acute kidney injury complicates approximately one-fifth of RT-PCR-confirmed Lassa fever hospitalizations and is associated with an 11-fold increase in mortality. Male sex, bleeding, diabetes, leukocytosis, and elevated aspartate transaminase independently predict AKI, while oliguria, hematuria, blood pressure, and monocyte count predict death.
METHODS: This retrospective study included 482 adults with RT-PCR-confirmed Lassa fever admitted to the Federal Medical Centre, Owo, Ondo State, Nigeria, from January 2019 to December 2024. Predictors of AKI and in-hospital mortality were identified by multivariable logistic regression and Cox proportional hazards regression analyses.
RESULTS: Acute kidney injury prevalence was 21% (95% CI, 17.4%-24.9%). Overall, 48 patients (10.1%) died: 33 (32.7%) with AKI and 15 (4.0%) without AKI (OR 11.647; 95% CI, 6.001-22.604; P < .001). Independent predictors of AKI included male sex (P < .001), bleeding abnormalities (P = .044), diabetes (P = .029), elevated white blood cell count (P = .005), increased neutrophil count (P = .003), and elevated aspartate transaminase (P = .017). Predictors of in-hospital mortality were AKI (P = .033), oliguria (P = .045), mean arterial blood pressure (P = .001), hematuria (P = .015), and elevated monocyte count (P = .022). Kaplan-Meier analysis demonstrated significantly poorer survival in patients with AKI versus those without (mean survival 19.0 vs 29.7 days; P ≤ .001).
CONCLUSIONS: Acute kidney injury complicates approximately one-fifth of RT-PCR-confirmed Lassa fever hospitalizations and is associated with an 11-fold increase in mortality. Male sex, bleeding, diabetes, leukocytosis, and elevated aspartate transaminase independently predict AKI, while oliguria, hematuria, blood pressure, and monocyte count predict death.