Published in:
01-08-2010 | Original Article
Etiology and outcome of acute kidney injury in children
Authors:
Ali Duzova, Aysin Bakkaloglu, Mukaddes Kalyoncu, Hakan Poyrazoglu, Ali Delibas, Ozan Ozkaya, Harun Peru, Harika Alpay, Oguz Soylemezoglu, Ayfer Gur-Guven, Mustafa Bak, Zelal Bircan, Nurcan Cengiz, Ipek Akil, Birsin Ozcakar, Nermin Uncu, Aysun Karabay-Bayazit, Ferah Sonmez, on behalf of The Turkish Society for Pediatric Nephrology Acute Kidney Injury Study Group
Published in:
Pediatric Nephrology
|
Issue 8/2010
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Abstract
The aim of this prospective, multicenter study was to define the etiology and clinical features of acute kidney injury (AKI) in a pediatric patient cohort and to determine prognostic factors. Pediatric-modified RIFLE (pRIFLE) criteria were used to classify AKI. The patient cohort comprised 472 pediatric patients (264 males, 208 females), of whom 32.6% were newborns (median age 3 days, range 1–24 days), and 67.4% were children aged >1 month (median 2.99 years, range 1 month–18 years). The most common medical conditions were prematurity (42.2%) and congenital heart disease (CHD, 11.7%) in newborns, and malignancy (12.9%) and CHD (12.3%) in children aged >1 month. Hypoxic/ischemic injury and sepsis were the leading causes of AKI in both age groups. Dialysis was performed in 30.3% of newborns and 33.6% of children aged >1 month. Mortality was higher in the newborns (42.6 vs. 27.9%; p < 0.005). Stepwise multiple regression analysis revealed the major independent risk factors to be mechanical ventilation [relative risk (RR) 17.31, 95% confidence interval (95% CI) 4.88–61.42], hypervolemia (RR 12.90, 95% CI 1.97–84.37), CHD (RR 9.85, 95% CI 2.08–46.60), and metabolic acidosis (RR 7.64, 95% CI 2.90–20.15) in newborns and mechanical ventilation (RR 8.73, 95% CI 3.95–19.29), hypoxia (RR 5.35, 95% CI 2.26–12.67), and intrinsic AKI (RR 4.91, 95% CI 2.04–11.78) in children aged >1 month.