Incidence of Acute Kidney Injury in Hospitalized Children.
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Date
2012-07
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Abstract
Objective: To determine the incidence and outcome of acute
kidney injury (AKI) in hospitalized patients.
Design: Prospective, observational.
Setting: Tertiary care center in North India.
Participants/patients: Inpatients, 1 month to 18-yr-old.
Intervention: None.
Main Outcome Measures: Incidence of AKI based on the
serum creatinine criteria proposed by the AKI Network.
Results: During February to September 2008, thirty nine of 108
(36.1%) critically ill patients and 34 of 378 (9.0%) patients who
were not critically ill developed AKI (P <0.001); the respective
incidence densities were 45.1 and 11.7 cases/1000 patient days,
respectively. The maximal stage of AKI was stage 1 in 48
(65.8%) patients, stage 2 in 13 (17.8%) and stage 3 in 12
(16.4%) patients; 11 (15.1%) required dialysis. Patients with AKI
had a significantly longer duration of hospital stay (9 days vs 7
days, P<0.02) and higher mortality (37% vs 8.7%; hazard ratio,
HR 2.73; 95% CI 1.64, 4.54). Independent risk factors for AKI
were young age (HR 0.89; 95% CI 0.83, 0.95), shock (HR 2.65;
95% CI 1.32, 5.31), sepsis (HR 3.64; 95% CI 2.20, 6.01), and
need for mechanical ventilation (2.18; 95% CI 1.12, 4.26).
Compared to patients without AKI, the mortality was higher for
AKI stage 2 (HR 5.18; 95% CI 2.59, 10.38) and stage 3 (HR 4.34;
95% CI 2.06, 9.16). Shock was an independent risk factor for
mortality (HR 10.7; 95% CI 4.96, 22.98).
Conclusions: AKI is common in critically ill children, especially
younger patients with septicemia and shock, and results in
increased hospital stay and high mortality.
Description
Keywords
Acute Kidney Injury Network, Acute tubular necrosis, Dialysis, India
Citation
Mehta Poonam, Sinha Aditi, Sami Abdus, Hari Pankaj, Kalaivani Mani, Gulati Ashima, Kabra Madhulika, Kabra Sushil K, Lodha Rakesh, Bagga Arvind. Incidence of Acute Kidney Injury in Hospitalized Children. Indian Pediatrics. 2012 July; 49(7): 537-542.