Outcome and Incidence of Acute Kidney Injury among Hospitalized Children

2021 ◽  
Vol 15 (11) ◽  
pp. 3400-3402
Author(s):  
Shaheen Masood ◽  
Riffat Farrukh ◽  
Qamar Rizvi ◽  
Ibrahim Shakoor ◽  
Amber Naseer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Paediatric Population ◽  
Severe Anaemia ◽  
Primary Care Settings ◽  
Tertiary Hospitals ◽  
Blood Pressures ◽  
The Subject ◽  
One Year

Background and purpose: Data on the epidemiology of acute kidney injury (ARI) in Asia come primarily from studies conducted in large tertiary hospitals with nephrology departments. Little is known about what happens in primary care settings without nephrology, especially in the paediatric population. The aim of this study is to describe the epidemiology, outcome and risk factors of ARF in children admitted in pediatric department. Place and Duration: In the Pediatric Medicine and Nephrology department of Abbasi Shaheed Hospital for one-year duration from August 2020 to August 2021. Methods: We prospectively examined children aged 2 to 14 whose guardians gave the consent for the study and were admitted in the Pediatric ward. We identified children with risk factors for AKI on admission and then tested them for AKI using the 2012 Creatinine-based Modified General Kidney Disease Improvement (KDIGO) criteria to improve overall outcomes. Participants with AKI were followed up to discharge. The subject of interest was the need and access to dialysis and renal recovery on discharge from the hospital. Results: A total of 74.3% (n = 116) out of the 156 patients admitted during the study period were at risk of ARF. Of the 156 registered participants, 51.9% (n = 81) were males with a mean age of 5 years. Although comorbid conditions were rare, sickle cell anaemia and malnutrition were the most common. Most of the children were hypotensive (n = 89; 57.1%), with mean systolic and diastolic blood pressures of 81 mmHg and 42 mmHg, respectively. The mean urine output was 0.79 ml / kg / hr. Thirteen patients (8.33%) had urine dipstick anomalies. Anaemia was common (n = 72, 46.2%) and 32 (20.5%) had severe anaemia. Leucocytosis was detected in 26.3% of patients, and a platelet count below 100,000 / mm3 in 24 (15.4%) patients. In total, 21 of 156 participants had AKI for an incidence of 13.5%. The only patient with an indication for dialysis (uremic encephalopathy and anuria> 24 hours) died without dialysis due to a delay in transfer to a dialysis centre (due to lack of resources). Of the 20 survivors in the AKI group, 15 (71.4%) had complete improvement in kidney function The median hospitalization time was significantly longer in participants with stage 3 AKI. Conclusions: ARF risk factors are very common in children admitted in the hospitals. At least one in 10 children presenting with AKI risk factors will have AKI. AKI is largely caused by community-acquired diseases that can be prevented, such as diarrheal diseases and malaria. Efforts should be made to educate about risk assessment, prevention, early diagnosis and treatment of AKI in children. Keywords: AKI; epidemiology; risk factors and outcome.

scholarly journals Common Risk Factors Responsible for Acute Kidney Injury among Children: Experience at Medical University in Bangladesh

2021 ◽  
Vol 7 (1) ◽  
pp. 42-46
Author(s):  
Sharmin Akter Luna ◽  
Jakia Sultana ◽  
Abdullah Al Mamun ◽  
Afroza Begum ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Radiocontrast Agent ◽  
Nephrotoxic Drugs ◽  
Common Risk Factors ◽  
One Year ◽  
Medical University

Background: Acute kidney injury can occur among the younger children due to different reasons. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among younger children. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology with the collaboration of Paediatric Gastroenterology, Paediatric Neurology, Paediatric Neonatology and Microbiology and Immunology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of 1 month to 17 years who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 42 patients, who fulfilled the inclusion criteria were enrolled in this study. The risk factors of AKI was mainly pre renal in 60% (n=9) cases, mostly due to nephrotoxic drugs followed by hypovolemia. Renal causes were in 40% (n=6) cases. Among these 50% cases due to amikacin and 50% cases due to use of radiocontrast agent. Most patients were with renal disease which was 30(58%) cases. Among them 28(93.0%) cases were nephrotic syndrome and 2(7.0%) cases were hydronephrosis. However, 7(13%) cases were cardiac disease presented with congenital heart disease who used radiocontrast agent. Conclusion: In conclusion most common risk factors of acute kidney injury among younger children is pre-renal causes which are due to nephrotoxic drugs. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 42-46

scholarly journals Early versus late acute kidney injury among patients with COVID-19—a multicenter study from Wuhan, China

2020 ◽  
Vol 35 (12) ◽  
pp. 2095-2102
Author(s):  
Suyuan Peng ◽  
Huai-Yu Wang ◽  
Xiaoyu Sun ◽  
Pengfei Li ◽  
Zhanghui Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Organ Dysfunction ◽  
Clinical Features ◽  
Kidney Injury ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Tertiary Hospitals ◽  
History Of

Abstract Background Acute kidney injury (AKI) is an important complication of coronavirus disease 2019 (COVID-19), which could be caused by both systematic responses from multi-organ dysfunction and direct virus infection. While advanced evidence is needed regarding its clinical features and mechanisms. We aimed to describe two phenotypes of AKI as well as their risk factors and the association with mortality. Methods Consecutive hospitalized patients with COVID-19 in tertiary hospitals in Wuhan, China from 1 January 2020 to 23 March 2020 were included. Patients with AKI were classified as AKI-early and AKI-late according to the sequence of organ dysfunction (kidney as the first dysfunctional organ or not). Demographic and clinical features were compared between two AKI groups. Their risk factors and the associations with in-hospital mortality were analyzed. Results A total of 4020 cases with laboratory-confirmed COVID-19 were included and 285 (7.09%) of them were identified as AKI. Compared with patients with AKI-early, patients with AKI-late had significantly higher levels of systemic inflammatory markers. Both AKIs were associated with an increased risk of in-hospital mortality, with similar fully adjusted hazard ratios of 2.46 [95% confidence interval (CI) 1.35–4.49] for AKI-early and 3.09 (95% CI 2.17–4.40) for AKI-late. Only hypertension was independently associated with the risk of AKI-early. While age, history of chronic kidney disease and the levels of inflammatory biomarkers were associated with the risk of AKI-late. Conclusions AKI among patients with COVID-19 has two clinical phenotypes, which could be due to different mechanisms. Considering the increased risk for mortality for both phenotypes, monitoring for AKI should be emphasized during COVID-19.

scholarly journals One-Year Progression and Risk Factors for the Development of Chronic Kidney Disease in Septic Shock Patients with Acute Kidney Injury: A Single-Centre Retrospective Cohort Study

2018 ◽  
Vol 7 (12) ◽  
pp. 554 ◽  
Author(s):  
June-sung Kim ◽  
Youn-Jung Kim ◽  
Seung Ryoo ◽  
Chang Sohn ◽  
Dong Seo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
One Year ◽  
Stage 1

(1) Background: Sepsis-associated acute kidney injury (AKI) can lead to permanent kidney damage, although the long-term prognosis in patients with septic shock remains unclear. This study aimed to identify risk factors for the development of chronic kidney disease (CKD) in septic shock patients with AKI. (2) Methods: A single-site, retrospective cohort study was conducted using a registry of adult septic shock patients. Data from patients who had developed AKI between January 2011 and April 2017 were extracted, and 1-year follow-up data were analysed to identify patients who developed CKD. (3) Results: Among 2208 patients with septic shock, 839 (38%) had AKI on admission (stage 1: 163 (19%), stage 2: 339 (40%), stage 3: 337 (40%)). After one year, kidney function had recovered in 27% of patients, and 6% had progressed to CKD. In patients with stage 1 AKI, 10% developed CKD, and mortality was 13% at one year; in patients with stage 2 and 3 AKI, the CKD rate was 6%, and the mortality rate was 42% and 47%, respectively. Old age, female, diabetes, low haemoglobin levels and a high creatinine level at discharge were seen to be risk factors for the development of CKD. (4) Conclusions: AKI severity correlated with mortality, but it did not correlate with the development of CKD, and patients progressed to CKD, even when initial AKI stage was not severe. Physicians should focus on the recovery of renal function, and ensure the careful follow-up of patients with risk factors for the development of CKD.

scholarly journals Acute kidney disease in hospitalized acute kidney injury patients

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11400
Author(s):  
Ping Yan ◽  
Xiang-Jie Duan ◽  
Yu Liu ◽  
Xi Wu ◽  
Ning-Ya Zhang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Additional Information ◽  
Acute Kidney Disease ◽  
Tertiary Hospitals ◽  
One Year ◽  
Stage 1

Background Acute kidney injury (AKI) and chronic kidney disease (CKD) have become worldwide public health problems, but little information is known about the epidemiology of acute kidney disease (AKD)—a state in between AKI and CKD. We aimed to explore the incidence and outcomes of hospitalized patients with AKD after AKI, and investigate the prognostic value of AKD in predicting 30-day and one-year adverse outcomes. Methods A total of 2,556 hospitalized AKI patients were identified from three tertiary hospitals in China in 2015 and followed up for one year.AKD and AKD stage were defined according to the consensus report of the Acute Disease Quality Initiative 16 workgroup. Multivariable regression analyses adjusted for confounding variables were used to examine the association of AKD with adverse outcomes. Results AKD occurred in 45.4% (1161/2556) of all AKI patients, 14.5% (141/971) of AKI stage 1 patients, 44.6% (308/691) of AKI stage 2 patients and 79.6% (712/894) of AKI stage 3 patients. AKD stage 1 conferred a greater risk of Major Adverse Kidney Events within 30 days (MAKE30) (odds ratio [OR], 2.36; 95% confidence interval 95% CI [1.66–3.36]) than AKD stage 0 but the association only maintained in AKI stage 3 when patients were stratified by AKI stage. However, compared with AKD stage 0, AKD stage 2–3 was associated with higher risks of both MAKE30 and one-year chronic dialysis and mortality independent of the effects of AKI stage with OR being 31.35 (95% CI [23.42–41.98]) and 2.68 (95% CI [2.07–3.48]) respectively. The association between AKD stage and adverse outcomes in 30 days and one year was not significantly changed in critically ill and non-critically ill AKI patients. The results indicated that AKD is common among hospitalized AKI patients. AKD stage 2–3 provides additional information in predicting 30-day and one-year adverse outcomes over AKI stage. Enhanced follow-up of renal function of these patients may be warranted.

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival ◽  
One Year

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center, assess risk factors for one-year mortality, and predict short- and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 to Jan 2020 analyzed the pre-, intra-, and postoperative characteristics of 87 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Twenty-six (36.1%) patients developed AKI. The one-year mortality rates in HTx patients with and without AKI were 26.92% and 10.87%, respectively (P > 0.05). Recipients who required renal replacement therapy (RRT) had a one-year mortality rate of 53.85% compared to 10.87% in those without AKI or RRT (P = 0.003). A long cardiopulmonary bypass (CPB) time (OR: 1.622, 95% CI: 1.014 to 2.595, P = 0.044) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.566, 95% CI: 0.344 to 0.930, P = 0.025) was negatively correlated with AKI. AKI requiring RRT (HR, 6.402; 95% CI, 2.014–20.355, P = 0.002) was a risk factor for death. Overall survival in patients without AKI at 1, 3, and 5 years was higher than that in patients with AKI (P > 0.05). Conclusions AKI is common after HTx and adversely impacts early mortality. A long CPB time and low intraoperative urine volume maybe associated with the occurrence of AKI. AKI requiring RRT could contribute powerful prognostic information to predict short-term survival.

Risk Factors and Primary Diseases Responsible for Acute Kidney Injury among Neonates

2021 ◽  
Vol 8 (1) ◽  
pp. 12-16
Author(s):  
Sharmin Akter Luna ◽  
Syma Akter ◽  
Tahmina Jesmin ◽  
Syed Saimul Haque ◽  
Golam Muin Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
One Year

Background: There are several risk factors and diseases related with the acute kidney injury among neonates. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among neonates. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of less than 1 months who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 52 patients who fulfilled the inclusion criteria were enrolled in this study. Among them 10 cases were in neonatal age group. The mean age was 10.8±5.4 days with female predominance. The risk factors of AKI in neonate was only pre-renal; mostly due to hypovolemia which was 3(60.0%) cases followed by sepsis and asphyxia which were 1(20.0%) case in each. The most patients had sepsis which was 4(40.0%) cases followed by congenital heart disease which was 2(20.0%) cases; one presented with heart failure and another one had cyanotic congenital heart disease. Conclusion: In conclusion hypovolemia, sepsis and asphyxia are the most common risk factors of acute kidney injury among the neonates. Journal of Current and Advance Medical Research, January 2021;8(1):12-16

Acute kidney injury in preterm neonates with ≤30 weeks of gestational age and its risk factors

2019 ◽  
Vol 71 (5) ◽  
Author(s):  
Rita Ladeiras ◽  
Filipa Flor-De-Lima ◽  
Henrique Soares ◽  
Bárbara Oliveira ◽  
Hercília Guimarães
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Gestational Age ◽  
Kidney Injury ◽  
Preterm Neonates

KIDNEY INJURY IN CANCER THERAPY

2018 ◽  
Vol 22 (5) ◽  
pp. 17-24 ◽  
Author(s):  
E. V. Burnasheva ◽  
Y. V. Shatokhin ◽  
I. V. Snezhko ◽  
A. A. Matsuga
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Cytotoxic Effect ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Oxygen Intermediates ◽  
Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular  injury, nephrotoxic drugs including chemotherapeutic agents. Also  bone marrow transplantation complications, infections with immune  suppression (including septicemia), tumor lysis syndrome should be  taken into account. Chemotherapeutic agents are a common cause  of acute kidney injury but can potentially lead to chronic kidney  disease development in cancer patients. This article summarizes risk  factors of acute kidney injury in cancer patients. Risk factors are  divided into two groups. The systemic are decrease of total  circulating blood volume, infiltration of kidney tissue by tumor cells,  dysproteinemia, electrolyte disturbances. The local (renal) risk  factors are microcirculation disturbances, drugs biotransformation  with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its  sensitivity to ischemia. Drug-related risk factors include: drugs  combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular  precipitates. Early diagnosis, timely prevention and treatment of  these complications provide significantly improve nononcologic results of treatment.

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