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Epidemiology data on the cost and outcomes associated with pediatric acute kidney injury

  • Clinical Research Article
  • Published:
Pediatric Research Submit manuscript

Abstract

Background

Hospitalized children with acute kidney injury (AKI) have not been extensively studied for clinical outcomes including hospital stay, the need for mechanical ventilation, mortality rates, and healthcare utilization. We hypothesize significant financial costs and increased morbidity and mortality associated with pediatric AKI.

Methods

This is a retrospective study of pediatric patients (age ≤18 years) included in the Kids’ Inpatient Database (KID) between January 1, 2016, and December 31, 2021. The results of the data analysis were utilized for comparative testing between the AKI and non-AKI cohorts.

Results

The study included 4842 children [with AKI (n = 2424) and without AKI (n = 2418)]. The odds of mortality (p = 0.004) and mechanical ventilation (p < 0.001) were observed to be significantly higher among those with AKI as compared to those without AKI. Additionally, the median (IQR) duration of stay in the hospital (p < 0.001) and total cost (p < 0.001) were significantly higher among those with AKI vs. those without AKI.

Conclusions

AKI in children was associated with higher odds of mortality, longer duration of hospital stay, increased requirement of mechanical ventilation, and increased hospital expenditure. The scientific community can utilize this information to better understand the outcomes associated with this disease process in this patient population.

Impact

  • This article has thoroughly evaluated epidemiologic data associated with pediatric acute kidney injury (AKI) in hospitalized patients

  • This study assesses mortality, hospital expenditure, and other factors to strengthen single-center and few multi-center studies and provides novel data regarding insurance and cost associated with pediatric AKI

  • With increased knowledge of current epidemiology and risk factors, the scientific community can better understand prevention and outcomes in hospitalized children with AKI.

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Fig. 1: Flowchart depicting study methods.
Fig. 2: Calibration plot of the best-fit multivariate logistic regression model.
Fig. 3: Receiver operating characteristic (ROC) curve for the best-fit model.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

There are no funding sources to report for this study.

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Authors and Affiliations

  1. Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA

    Rupesh Raina

  2. Department of Nephrology, Akron Children’s Hospital, Akron, OH, USA

    Rupesh Raina

  3. Pediatric Nephrology, Kidney Institute and Pediatric Intensive Care, Medanta, The Medicity Hospital, Gurgaon, Haryana, 122001, India

    Sidharth Sethi

  4. Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA

    Varun Aitharaju & Imad Haq

  5. Maulana Azad Medical College, New Delhi, India

    Ananya Vadhera

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Contributions

Substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data—R.R., S.S., and A.V. Drafting the article or revising it critically for important intellectual content—V.A. and I.H.. Final approval of the version to be published—R.R.

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Correspondence to Rupesh Raina.

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Raina, R., Sethi, S., Aitharaju, V. et al. Epidemiology data on the cost and outcomes associated with pediatric acute kidney injury. Pediatr Res 94, 1385–1391 (2023). https://doi.org/10.1038/s41390-023-02564-8

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