Faculty Opinions recommendation of Acute kidney injury is an independent risk factor for pediatric intensive care unit mortality, longer length of stay and prolonged mechanical ventilation in critically ill children: a two-center retrospective cohort study.

2011 ◽  
Author(s):  
Saskia de Wildt ◽  
Erik Buijs
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Intensive Care Unit Mortality ◽  
Prolonged Mechanical Ventilation ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Critically Ill Children

scholarly journals Profile and outcome of acute kidney injury in critically ill children admitted to pediatric intensive care unit

2018 ◽  
Vol 5 (6) ◽  
pp. 2148
Author(s):  
Urmila Chauhan ◽  
Yogesh Phirke ◽  
Sandeep Golhar ◽  
Abhishek Madhura
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Nephrotoxic Drugs

Background: Acute kidney injury (AKI) is defined as an abrupt onset of renal dysfunction resulting from injurious endogenous or exogenous processes characterized by a decrease in glomerular filtration rate (GFR) and an increase in serum creatinine. AKI is common in critically ill children and early diagnosis is important for better outcome in these children.Methods: This was a prospective observational study. Critically ill infants and children of either sex and in age group between >28 days to 12 years admitted to pediatric intensive care unit (PICU) were included. Serum creatinine and estimated creatinine clearance (eCC) were used to and patients classified as AKI on pRIFLE criteria either at admission or subsequently during the hospital stay. AKI cases were further classified into risk, injury or failure category on the day of development of AKI and the maximum pRIFLE stage reached during PICU stay was noted. Detailed data regarding the treatment received and use of nephrotoxic drugs, inotropic support, mechanical ventilation, dialysis and total length of stay in PICU in all was noted. Outcome of the subjects were observed for survival or mortality.Results: Total 343 subjects were enrolled in the study. During the study 27.1% patients developed AKI according to pRIFLE staging. In AKI category 60.21% reached maximum risk category, 21.5% reached maximum injury category, 18.28% reached maximum failure category. Amongst AKI subjects 64.52% had infectious etiology. Multiorgan dysfunction, encephalopathy, shock, metabolic acidosis, hypertension, mechanical ventilation and nephrotoxic drugs administration were more associated with AKI and was statistically significant.Conclusions: Pediatric modification of RIFLE criteria is sensitive index to detect AKI at earliest in critically ill children for early intervention leading to better outcome.

scholarly journals Risk factors for acute kidney injury in a pediatric intensive care unit: a retrospective cohort study

Medwave ◽  
2017 ◽  
Vol 17 (03) ◽  
pp. e6940-e6940 ◽  
Author(s):  
Lina María Serna-Higuita ◽  
John Fredy Nieto-Ríos ◽  
Jorge Eduardo Contreras-Saldarriaga ◽  
Juan Felipe Escobar-Cataño ◽  
Luz Adriana Gómez-Ramírez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Pediatric Intensive Care

scholarly journals Incidence and etiology of acute kidney injury in children admitted to PICU using pRIFLE criteria

2018 ◽  
Vol 5 (3) ◽  
pp. 917
Author(s):  
Javid Maqbool ◽  
Aajaz Ahmad Mir ◽  
Nisar Ahmad Bhat ◽  
Waseem Qadir Moona
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Adverse Outcomes ◽  
Critically Ill Children ◽  
Consensus Definition ◽  
Schwartz Formula

Background: Acute kidney injury is a common problem highly associated with hospitalization. Acute Kidney Injury (AKI) is associated with severe morbidity and mortality especially in children. Lack of consensus definition has been major limitation in improving outcomes. This study tries to address the need of limited data on pediatric AKI. Detection of the incidence, etiological profile and outcome of AKI is important for the initiation of preventive and therapeutic strategies, identifying patients early to avoid renal replacement therapy.Methods: This prospective observational study was conducted in the pediatric intensive care unit (PICU) of tertiary hospital (GMC Srinagar) between January 2015 to December 2016.This is the only prospective study conducted in this hospital, all other studies conducted here and other higher centers were retrospective. Serum creatinine level was estimated on all patients on admission and alternate days till discharge from Pediatric Intensive Care Unit (PICU). Urine output was recorded. Estimated Creatinine- Clearance (eCrCL) was calculated using Schwartz formula. AKI diagnosis and staging was based on pRIFLE (pediatric RIFLE) criteria. eCrCl criteria was used to diagnose and stage AKI. Maximal stage that the patient progressed during the stay in PICU was assigned the stage for that case.Results: Of total 500 cases, 480 cases met inclusion criteria. Of them, the incidence of AKI was 154 (32.1%). Stage ‘Risk (R)’, ‘Injury (I)’ and ‘Failure (F)’ constituted 93(60.38%), 46 (29.8%) and15 (9.74%) respectively. Maximum AKI occurred in <1 year (30.5%). Infections were commonest etiology. Amongst infections sepsis (30.5%) was most common, followed by acute gastroenteritis (20.7%) and pneumonia (16.9%). Hypotension, nephrotoxic drugs, sepsis, need for mechanical ventilation were significant (p<0.001) risk factors for AKI. Pre-renal causes constituted 68% and intrinsic renal 32%.Conclusions: The incidence of AKI is high among critically ill children. AKI continues to be associated with adverse outcomes. pRIFLE staging system provides early identification and stratification of AKI. Infections are leading etiology of AKI in children. 

scholarly journals A Study of Acute Kidney Injury in a Tertiary Care Pediatric Intensive Care Unit

2020 ◽  
Author(s):  
Akanksha C. Parikh ◽  
Milind S. Tullu
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Hospital Stay ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Critically Ill Children

AbstractThe objective of this study was to calculate the incidence, severity, and risk factors for acute kidney injury (AKI) in a tertiary care pediatric intensive care unit (PICU). Also, to assess the impact of AKI and its varying severity on mortality and length of hospital and PICU stays. A prospective observational study was performed in children between 1 month and 12 years of age admitted to the PICU between July 1, 2013, and July 31, 2014 (13 months). The change in creatinine clearance was considered to diagnose and stage AKI according to pediatric risk, injury, failure, loss, and end-stage renal disease criteria. The risk factors for AKI and its impact on PICU stay, hospital stay, and mortality were evaluated. Of the total 220 patients enrolled in the study, 161 (73.2%) developed AKI, and 59 cases without AKI served as the “no AKI” (control) group. Majority (57.1%) of children with AKI had Failure grade of AKI, whereas 26.1% had Risk grade and 16.8% had Injury grade of AKI. Infancy (p = 0.000), hypovolemia (p = 0.005), shock (p = 0.008), and sepsis (p = 0.022) were found to be significant risk factors for AKI. Mortality, PICU stay, and hospital stay were comparable in children with and without AKI as well as between the various grades of renal injury (i.e., Failure, Risk, and Injury). An exceedingly high incidence of AKI, especially of the severe Failure grade was observed in critically ill children. Infancy and frequent PICU occurrences such as sepsis, hypovolemia, and shock predisposed to AKI.

scholarly journals Acute Kidney Injury – An Underestimated Problem In Pediatric Intensive Care / Akûts Nieru Bojâjums — Nenovçrtçta Problçma Bçrnu Intensîvajâ Terapijâ

2014 ◽  
Vol 68 (5-6) ◽  
pp. 207-215
Author(s):  
Jēkabs Krastiņš
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Paediatric Intensive Care ◽  
Cochrane Library ◽  
Critically Ill Children ◽  
Multiorgan Dysfunction

AbstractAcute kidney injury (AKI) frequently occurs in critically ill children and adults, with 5-20% of patients experiencing an episode during their stay in an intensive care unit. AKI rarely is an isolated event and is associated with a broader spectrum of diseases, including sepsis and respiratory insufficiency, and often progresses into multiorgan dysfunction syndrome. Despite recent advancements in renal replacement therapy (RRT), mortality among patients who sustain AKI complicated by multiorgan dysfunction appears to have remained unchanged and is estimated at approximately 50%. Recent clinical evidence suggests that AKI is not only an indicator for severity of illness, but that it also leads to earlier onset of multiorgan dysfunction with profound effects on mortality rates. The aim of this paper is to inform medical professionals involved in the paediatric intensive care of recent advances in AKI diagnosis and management. Studies were identified from MEDLINE (OVID), PubMed, and the Cochrane Library for topics relevant to AKI. There is limited evidence in paediatrics regarding effective therapy for acute kidney injury, a significant problem in the paediatric intensive care unit that extends length of stay, duration of mechanical ventilation, and overall mortality. Sublethal kidney injury may be contributing to overall morbidity. Prospective clinical trials are needed to evaluate specific diagnostic aids, such as biomarkers, and therapeutic strategies like early initiation of continuous RRT in children with fluid overload

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