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Spectrum of Acute Kidney Injury and its Clinical Profile and Outcome in Children Admitted to PICU

Savita Patil, Consultant, Department of Obstetrics and Gynecology, Chinemayagiri Maternity & Children Hospital, Kalaburagi, Karnataka 585103, India. , Basavaraj Patil1 , Savita Patil2 , Harsha S.3

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Pediatric Education and Research 6(2):p 90-94, May - August 2018. | DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.6218.8

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Abstract

Objective: To determine incidence, risk factors, and outcome of acute kidney injury (AKI) in Pediatric Intensive Care Unit (PICU).

Materials and Methods: This prospective observational study was conducted over period of 1½ years. All patients within the age group of 1 month to 18 years admitted in the PICU (Pediatric Intensive Care Unit) at Basaveshwar teaching and general hospital and Sangameshwar hospital attached to Mahadevappa Rampure Medical College during a period from December 2015 to August 2017.

Results: Out of 1007 patient screened 7 patient were excluded, out of which 2 where congenital dysplastic kidney, 2 were known case of nephrotic syndrome, 3 where known case of chronic kidney disease. Out of 1000 patients 69 children had AKI, giving incidence of 6.9%. The median age of boys and girls were 4.56±3.84 and 4.49±4.01 respectively. 58% of the patients were boys. The median admission serum creatinine value in AKI patients was 2.91±2.48 mg/dL. In the present study, pre-renal causes accounted for (54) 78.3% of AKI. AKI Stage 1, 2, 3 was diagnosed in 11 (15.9%), 14 (20.3%) and 44 (63.8%) respectively.

Conclusions: AKI continues to be associated with adverse outcomes, including high mortality , morbidity and prolonged hospital stay. Mechanical ventilation & Hypovolemia were independent risk factors. Higher the stage of AKI mortality increases. Early diagnosis of AKI using new defined criteria (AKIN, RIFLE, pRIFLE) [4,5,6] along with early and appropriate management of risk factors will prevent the progression of AKI and decrease the mortality and morbidity of AKI patients.

Keywords: Acute Kidney Injury; Critically Ill Children; Pediatric Intensive Care Unit; pRIFLE.

 

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DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.6218.8

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