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Indian Pediatr. 2012 Jul;49(7):537-42. Epub 2011 Dec 17.

Incidence of acute kidney injury in hospitalized children.

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  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

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 yrs.

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.

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PMID:
22317984
[PubMed - indexed for MEDLINE]
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