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Citation |
Krishnamurthy S, Mondal N, Narayanan P, Biswal N, Srinivasan S, Soundravally R. Indian J. Pediatr. 2013; 80(3): 183-189. |
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Affiliation |
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India, drsriramk@yahoo.com. |
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Copyright |
(Copyright © 2013, K C Chaudhuri Foundation and All India Institute of Medical Sciences, Publisher Holtzbrinck Springer Nature Publishing Group) |
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DOI |
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PMID |
22692434 |
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Abstract |
OBJECTIVES: To determine the incidence, etiology, short term outcome and predictors of mortality in hospitalized children aged 1 mo to 13 y with Acute Kidney Injury (AKI). METHODS: This prospective observational study was conducted in the pediatric wards and the pediatric intensive care unit (PICU) of a tertiary hospital in southern India, to study the clinico-etiological profile of AKI (defined according to the Acute Kidney Injury Network criteria). From June 2010 through March 2011, 2376 children were included in the study. RESULTS: The incidence of AKI was 5.2 % in the pediatric wards and 25.1 % in the PICU. AKI occurred in association with infections (55.4 %), acute glomerulonephritis (16.9 %), cardiac disease (4.8 %), envenomations (4.2 %) and hemolytic uremic syndrome (3.6 %). Pneumonia constituted 26.1 % of the infections. Tropical febrile illnesses (dengue, scrub typhus, enteric fever, cholera, tuberculosis, malaria and leptospirosis) constituted 15.6 % of children with AKI. Dialysis was required in 14.5 % of patients; mortality was 17.5 %. A significant proportion of children (17.5 % of survivors) had partial renal recovery at discharge. On multivariate logistic regression, dysnatremia and meningoencephalitis were independent predictors of mortality in AKI. CONCLUSIONS: The incidence of AKI is high in the patient population, including the non-critically ill children. AKI continues to be associated with adverse outcomes. Presence of dysnatremia and meningoencephalitis are poor predictors of outcome in AKI. Language: en |