Clinical and etiological profile of acute kidney injury in pediatric intensive care unit

Author: 
Joshi Vaishali and Aathira Ajaykumar

Backgound: Acute kidney injury (AKI) is one of the leading causes of mortality in sick children in Pediatric Intensive Care Units with different risk factors reported across the globe. While the precise incidence and causes of (AKI) in pediatric patients is unknown overall range of incidence reported is from 1 to 25% in critically ill patients The mortality in AKI in children also has been reported to vary widely from 3.4% to 52%.. Hence the need to study the clinical and etiological profile in the local population is significant. as it helps to predict the occurrence of complications and in planning the appropriate treatment. Objective: To determine the incidence ,etiology and short term outcome of AKI as defined by AKIN classification in pediatric patients admitted in pediatric intensive care unit (PICU) aged 1 month to 12 years Materials and Methods: This was a prospective observational study conducted in all patients between the age 1 month and 12 years admitted from June 2015 to January 2016 in PICU of Goa medical college. Acute Kidney Injury was defined and staged based on Acute Kidney Injury Network criteria using either serum creatinine or urine output .Serum levels of creatinine were estimated at admission and there after every 24+/- 6 hours for 3 consecutive days in all patients. Short term outcome was classified as complete or partial renal recovery. Results: incidence of acute kidney injury in this study was 14.8%. with a male preponderance. Mortality was noted to be 46.7%. Majority of AKI [80.0%] was due to intrinsic renal causes and sepsis being the commonest etiology. Prolonged duration of hospital stay was associated with progression to higher stages of AKI. Conclusion: The most common etiology of AKI was sepsis (46.6%) followed by drug induced (16.7%). this association was statistically significant as the p value was 0.006.Patients with a longer duration of hospital stay had poor prognosis with 100% partial recovery in >14 days hospital stay group, p value was 0.005.

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