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Pediatric Nephrology

, Volume 25, Issue 8, pp 1453–1461 | Cite as

Etiology and outcome of acute kidney injury in children

  • Ali DuzovaEmail author
  • Aysin Bakkaloglu
  • Mukaddes Kalyoncu
  • Hakan Poyrazoglu
  • Ali Delibas
  • Ozan Ozkaya
  • Harun Peru
  • Harika Alpay
  • Oguz Soylemezoglu
  • Ayfer Gur-Guven
  • Mustafa Bak
  • Zelal Bircan
  • Nurcan Cengiz
  • Ipek Akil
  • Birsin Ozcakar
  • Nermin Uncu
  • Aysun Karabay-Bayazit
  • Ferah Sonmez
  • on behalf of The Turkish Society for Pediatric Nephrology Acute Kidney Injury Study Group
Original Article

Abstract

The aim of this prospective, multicenter study was to define the etiology and clinical features of acute kidney injury (AKI) in a pediatric patient cohort and to determine prognostic factors. Pediatric-modified RIFLE (pRIFLE) criteria were used to classify AKI. The patient cohort comprised 472 pediatric patients (264 males, 208 females), of whom 32.6% were newborns (median age 3 days, range 1–24 days), and 67.4% were children aged >1 month (median 2.99 years, range 1 month–18 years). The most common medical conditions were prematurity (42.2%) and congenital heart disease (CHD, 11.7%) in newborns, and malignancy (12.9%) and CHD (12.3%) in children aged >1 month. Hypoxic/ischemic injury and sepsis were the leading causes of AKI in both age groups. Dialysis was performed in 30.3% of newborns and 33.6% of children aged >1 month. Mortality was higher in the newborns (42.6 vs. 27.9%; p < 0.005). Stepwise multiple regression analysis revealed the major independent risk factors to be mechanical ventilation [relative risk (RR) 17.31, 95% confidence interval (95% CI) 4.88–61.42], hypervolemia (RR 12.90, 95% CI 1.97–84.37), CHD (RR 9.85, 95% CI 2.08–46.60), and metabolic acidosis (RR 7.64, 95% CI 2.90–20.15) in newborns and mechanical ventilation (RR 8.73, 95% CI 3.95–19.29), hypoxia (RR 5.35, 95% CI 2.26–12.67), and intrinsic AKI (RR 4.91, 95% CI 2.04–11.78) in children  aged >1 month.

Keywords

Epidemiology Mortality pRIFLE Prognosis 

Notes

Acknowledgments

Dr. Duzova is supported by The Turkish Academy of Sciences (Program to Reward Successful Young Scientists, A.D/TUBA-GEBIP/2006-6).

The authors would like to thank Hacettepe University Faculty of Medicine Research Office for their valuable assistance in statistical analysis.

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Copyright information

© IPNA 2010

Authors and Affiliations

  • Ali Duzova
    • 1
    Email author
  • Aysin Bakkaloglu
    • 1
  • Mukaddes Kalyoncu
    • 2
  • Hakan Poyrazoglu
    • 3
  • Ali Delibas
    • 4
  • Ozan Ozkaya
    • 5
  • Harun Peru
    • 6
  • Harika Alpay
    • 7
  • Oguz Soylemezoglu
    • 8
  • Ayfer Gur-Guven
    • 9
  • Mustafa Bak
    • 10
  • Zelal Bircan
    • 11
  • Nurcan Cengiz
    • 12
  • Ipek Akil
    • 13
  • Birsin Ozcakar
    • 14
  • Nermin Uncu
    • 15
  • Aysun Karabay-Bayazit
    • 16
  • Ferah Sonmez
    • 17
  • on behalf of The Turkish Society for Pediatric Nephrology Acute Kidney Injury Study Group
  1. 1.Department of Pediatrics, Pediatric Nephrology and Rheumatology Unit, Faculty of MedicineHacettepe UniversitySihhiye, AnkaraTurkey
  2. 2.Department of Pediatric Nephrology, Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
  3. 3.Department of Pediatric Nephrology, Faculty of MedicineErciyes UniversityKayseriTurkey
  4. 4.Department of Pediatric Nephrology, Faculty of MedicineMersin UniversityMersinTurkey
  5. 5.Department of Pediatric Nephrology, Faculty of Medicine19 Mayis UniversitySamsunTurkey
  6. 6.Department of Pediatric Nephrology, Meram Faculty of MedicineSelcuk UniversityKonyaTurkey
  7. 7.Department of Pediatric Nephrology, Faculty of MedicineMarmara UniversityIstanbulTurkey
  8. 8.Department of Pediatric Nephrology, Faculty of MedicineGazi UniversityAnkaraTurkey
  9. 9.Department of Pediatric Nephrology, Faculty of MedicineAkdeniz UniversityAntalyaTurkey
  10. 10.Department of Pediatric NephrologyBehçet Uz Children’s HospitalIzmirTurkey
  11. 11.Department of Pediatric Nephrology, Faculty of MedicineKocaeli UniversityKocaeliTurkey
  12. 12.Department of Pediatric NephrologyBaskent University HospitalAdanaTurkey
  13. 13.Department of Pediatric Nephrology, Faculty of MedicineCelal Bayar UniversityManisaTurkey
  14. 14.Department of Pediatric Nephrology, Faculty of MedicineAnkara UniversityAnkaraTurkey
  15. 15.Department of Pediatric NephrologyMinistry of Health Diskapi Childrens HospitalAnkaraTurkey
  16. 16.Department of Pediatric Nephrology, Faculty of MedicineCukurova UniversityAdanaTurkey
  17. 17.Department of Pediatric Nephrology, Faculty of MedicineAdnan Menderes UniversityAydinTurkey

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