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Pediatrics Education and Research

Volume  6, Issue 2, May - August 2018, Pages 90-94
 

Original Article

Spectrum of Acute Kidney Injury and its Clinical Profile and Outcome in Children Admitted to PICU

Basavaraj Patil1, Savita Patil2, Harsha S.3

1Associate Professor 3Sr. Resident, Department of Pediatrics, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka 585105, India. 2Consultant, Department of Obstetrics and Gynecology, Chinemayagiri Maternity & Children Hospital, Kalaburagi, Karnataka 585103, India.

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DOI: DOI: https://dx.doi.org/10.21088/per.2321.1644.6218.8

Abstract

Objective: To determine incidence, risk factors, and outcome of acute kidney injury (AKI) in Pediatric Intensive Care Unit (PICU).

Materials and Methods: This prospective observational study was conducted over period of 1½ years. All patients within the age group of 1 month to 18 years admitted in the PICU (Pediatric Intensive Care Unit) at Basaveshwar teaching and general hospital and Sangameshwar hospital attached to Mahadevappa Rampure Medical College during a period from December 2015 to August 2017.

Results: Out of 1007 patient screened 7 patient were excluded, out of which 2 where congenital dysplastic kidney, 2 were known case of nephrotic syndrome, 3 where known case of chronic kidney disease. Out of 1000 patients 69 children had AKI, giving incidence of 6.9%. The median age of boys and girls were 4.56±3.84 and 4.49±4.01 respectively. 58% of the patients were boys. The median admission serum creatinine value in AKI patients was 2.91±2.48 mg/dL. In the present study, pre-renal causes accounted for (54) 78.3% of AKI. AKI Stage 1, 2, 3 was diagnosed in 11 (15.9%), 14 (20.3%) and 44 (63.8%) respectively.

Conclusions: AKI continues to be associated with adverse outcomes, including high mortality , morbidity and prolonged hospital stay. Mechanical ventilation & Hypovolemia were independent risk factors. Higher the stage of AKI mortality increases. Early diagnosis of AKI using new defined criteria (AKIN, RIFLE, pRIFLE) [4,5,6] along with early and appropriate management of risk factors will prevent the progression of AKI and decrease the mortality and morbidity of AKI patients.

Keywords: Acute Kidney Injury; Critically Ill Children; Pediatric Intensive Care Unit; pRIFLE.

 


Corresponding Author : Savita Patil, Consultant, Department of Obstetrics and Gynecology, Chinemayagiri Maternity & Children Hospital, Kalaburagi, Karnataka 585103, India.