Acute Renal Injury in Critically Ill Children

Investigators from multiple institutions conducted the Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology study to determine the epidemiology and outcomes of children and young adults with acute kidney injury (AKI). Data were collected on patients aged 3 months to 25 years who were admitted to 32 pediatric intensive care units (ICUs) across Asia, Australia, Europe, and North America for 3 consecutive months in 2014. Based on published criteria, study patients were classified as having AKI if they had a ≥1.5-fold increase in serum creatinine (Cr) over baseline or developed decreased urine output (<0.5 mL/kg/hour) for at least 6 hours; patients were categorized as having severe AKI if their serum Cr was ≥2 times their baseline value or they had decreased urine output for ≥12 hours.1 Patients with known prior chronic renal disease were excluded from analyses. The primary study outcome was 28-day mortality; secondary outcomes included length of ICU stay, receipt of mechanical ventilation, and need for renal replacement therapy. These outcomes were compared among those with severe AKI versus those with less severe and/or no AKI. Regression analyses were used to calculate increased risk of death in patients with increasingly severe AKI after adjusting for confounding variables. The authors also evaluated the relative importance of increased serum Cr or decreased urine output as a sign of AKI. Among the 4,683 patients evaluated, AKI developed in ...
Source: AAP Grand Rounds - Category: Pediatrics Authors: Tags: Nephrology Source Type: research