Prevalence of acute kidney injury and its associated factors among malaria patients admitted to public hospitals in the Ilu Aba Bora and Bedelle Zones of Oromia region, Southwest Ethiopia

Acute kidney injury (AKI) is a severe complication of malaria affecting up to 40% of patients in endemic regions. AKI increases mortality risk and predisposes survivors to chronic kidney disease and hypertension. Understanding malaria-associated AKI and its risk factors is crucial for improving patient outcomes. However, prevalence and contributing factors vary by region, healthcare practices, and demographics. In Ethiopia, these aspects remain understudied, highlighting the need for further research to inform effective prevention and treatment strategies. This study aimed to assess the prevalence of AKI and its associated factors among malaria patients admitted to public hospitals in the Ilu Aba Bora and Bedelle Zones of Oromia region, Southwest Ethiopia, 2024. A facility-based cross-sectional study was conducted in four randomly selected public hospitals in Ilubabour and Buno Bedelle Zones from February 1 to April 30, 2024. Participants were proportionally allocated and consecutively enrolled. Data on socio-demographic and clinical characteristics were collected using structured questionnaires, and creatinine levels were measured per standard protocols. AKI was defined as increase in serum creatinine by ≥ 0.3 mg/dl in 48 h from baseline level taken on admission. SPSS version 25 was used for descriptive statistics and logistic regression analyses, with a 5% significance level. A total of 307 adult malaria patients were included in to the study. The mean age of participants was 35.57 ± 12.05 years and 53.7% of them were males. Mean creatinine levels at admission and 48 h were 1.43 ± 0.29 mg/dL and 1.72 ± 0.74 mg/dL, respectively. The prevalence of AKI, defined as increase in serum creatinine of ≥ 0.3 mg/dL within 48 h, was 28.3% (87/307). Male sex (AOR:1.98; 95%CI:1.12,3.48), age range in 40-59years (AOR: 2.52; 95%CI:1.41,4.49), age ≥ 60years (AOR:4.46;95%CI:1.38,14.38), dehydration (AOR:1.74; 95%CI:1.01,3.02), infection with plasmodium falciparum (AOR:2.73; 95%CI:1.51,4.95), mixed infection (AOR: 3.30; 95%CI: 1.44, 7.55), and high parasitaemia level (AOR:2.71; 95%CI:1.23,5.94) were significantly associated with AKI. The findings of this study revealed that nearly one-third of participants had AKI, highlighting the need for renal assessment in malaria patients.