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Incidence of acute kidney injury in hospitalized children

Indian Pediatrics volume 49, pages 537–542 (2012)Cite this article

Abstract

Objective

To determine the incidence and outcome of acute kidney injury (AKI) in hospitalized patients.

Design

Prospective, observational.

Setting

Tertiary care center in North India.

Participants/patients

Inpatients, 1 month to 18-yr-old.

Intervention

None.

Main Outcome Measures

Incidence of AKI based on the serum creatinine criteria proposed by the AKI Network.

Results

During February to September 2008, thirty nine of 108 (36.1%) critically ill patients and 34 of 378 (9.0%) patients who were not critically ill developed AKI (P <0.001); the respective incidence densities were 45.1 and 11.7 cases/1000 patient days, respectively. The maximal stage of AKI was stage 1 in 48 (65.8%) patients, stage 2 in 13 (17.8%) and stage 3 in 12 (16.4%) patients; 11 (15.1%) required dialysis. Patients with AKI had a significantly longer duration of hospital stay (9 days vs 7 days, P<0.02) and higher mortality (37% vs 8.7%; hazard ratio, HR 2.73; 95% CI 1.64, 4.54). Independent risk factors for AKI were young age (HR 0.89; 95% CI 0.83, 0.95), shock (HR 2.65; 95% CI 1.32, 5.31), sepsis (HR 3.64; 95% CI 2.20, 6.01), and need for mechanical ventilation (2.18; 95% CI 1.12, 4.26). Compared to patients without AKI, the mortality was higher for AKI stage 2 (HR 5.18; 95% CI 2.59, 10.38) and stage 3 (HR 4.34; 95% CI 2.06, 9.16). Shock was an independent risk factor for mortality (HR 10.7; 95% CI 4.96, 22.98).

Conclusions

AKI is common in critically ill children, especially younger patients with septicemia and shock, and results in increased hospital stay and high mortality.

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Affiliations

  1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

    Poonam Mehta, Aditi Sinha, Abdus Sami, Pankaj Hari, Ashima Gulati, Madhulika Kabra, Sushil K. Kabra, Rakesh Lodha & Arvind Bagga

  2. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

    Mani Kalaivani

  3. Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Aditi Sinha

Authors
  1. Poonam Mehta
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  2. Aditi Sinha
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  3. Abdus Sami
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  4. Pankaj Hari
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  5. Mani Kalaivani
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  6. Ashima Gulati
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  7. Madhulika Kabra
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  8. Sushil K. Kabra
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  9. Rakesh Lodha
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  10. Arvind Bagga
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Corresponding author

Correspondence to Aditi Sinha.

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Mehta, P., Sinha, A., Sami, A. et al. Incidence of acute kidney injury in hospitalized children. Indian Pediatr 49, 537–542 (2012). https://doi.org/10.1007/s13312-012-0121-6

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  • DOI: https://doi.org/10.1007/s13312-012-0121-6

Key words

  • Acute Kidney Injury Network
  • Acute tubular necrosis
  • Dialysis
  • India