The Indian Journal of Pediatrics

, Volume 84, Issue 6, pp 420–424

Incidence and Outcome of Acute Cardiorenal Syndrome in Hospitalized Children

  • Vivek Athwani
  • Maneesha Bhargava
  • Rahul Chanchlani
  • Amar Jeet Mehta
Original Article
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Abstract

Objectives

To determine the incidence, etiology and outcome of Cardiorenal syndrome (CRS) in hospitalized children.

Methods

A prospective cohort study was carried out in 242 children between 6 mo to 18 y of age hospitalized with primary cardiac, renal or any systemic disorder at a tertiary care center in India. The primary outcome was the development of CRS. Univariate and multivariate logistic regression analysis were performed to determine the risk of mortality secondary to CRS.

Results

Among 242 children, 67 (27.7%) children developed CRS and the rest 175 (72.3%) did not. Among those with CRS, 40.3%, 20.9%, and 38.8% had CRS-1, 3 and 5, respectively. Cardiac diseases leading to CRS were myocarditis (40.7%) followed by congenital heart disease (25.9%), rheumatic heart disease (18.5%), and dilated cardiomyopathy (7.4%); renal disease associated with CRS was acute glomerulonephritis (100%) and major systemic disorders leading to CRS were septicemia (53.8%), malaria (23.1%), scrub typhus (7.7%), and acute gastroenteritis (3.8%). The occurrence of CRS was associated with an increased risk of mortality (OR 6.3, 95% CI: 2.8, 14.1; p 0.000). A subgroup analysis revealed that children with CRS having acute kidney injury stage 2 and 3 also had a higher risk of mortality (p 0.001).

Conclusions

The incidence of CRS is quite high in children with cardiac, renal or systemic diseases and is associated with a significant risk of mortality. Children presenting with these illnesses should be monitored for the occurrence of CRS so that early intervention may reduce mortality.

Keywords

Cardiorenal syndrome Acute kidney injury Acute decompensated heart failure 

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Vivek Athwani
    • 1
  • Maneesha Bhargava
    • 1
  • Rahul Chanchlani
    • 2
  • Amar Jeet Mehta
    • 1
  1. 1.Department of Pediatric Medicine, Division of Pediatric NephrologySMS Medical CollegeJaipurIndia
  2. 2.Division of Pediatric Nephrology, McMaster Children’s HospitalMcMaster UniversityHamiltonCanada

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