Osama Y Safder1, Khalid A Alhasan2, Mohamed A Shalaby3, Norah Khathlan4, Suleman A Al Rezgan5, Amr S Albanna6, Jameela A Kari3. 1. Pediatric Nephrology Center of Excellence, Pediatric Department, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia. safderosama@hotmail.com. 2. Pediatrics Department, College of Medicine. King Saud University, Riyadh, Kingdom of Saudi Arabia. 3. Pediatric Nephrology Center of Excellence, Pediatric Department, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia. 4. Pediatric Intensive Care Unit, Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. 5. King Fahad Armed Forced Hospital, Jeddah, Kingdom of Saudi Arabia. 6. King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia.
Abstract
BACKGROUND: Acute kidney injury (AKI) in critically ill children is associated with increased mortality and morbidity. In this study we evaluated the effect of AKI severity on the incidence of short-term mortality and morbidity. METHODS: Multicenter prospective cohort study was conducted over two years period. We used the Kidney Disease Improving Global Outcomes (KDIGO) to diagnose and stage AKI. RESULTS: A total of 511 out of 1367 included children (37.4%; 95% CI: 34.8-40.0) were diagnosed with AKI. They were categorized into three KDIGO stages: stage I (mild) in 47.5% (95% CI: 43.2-52.0), stage II (moderate) in 32.8% (95% CI: 28.8-37.1) and stage III (severe) in 19.7% (95% CI: 16.4-23.5). Stage II and III AKI had higher risk of mortality and longer length of stay (LOS) in hospital. Children with stage III AKI were more likely to require mechanical ventilation, referral to pediatric nephrology and discharge with abnormal creatinine level (above 100 uml\L). Hypervolemia, hypocalcemia, anemia, and acidosis were found to be independent risk factors of mortality. CONCLUSION: The extent of severity of AKI is directly associated with increased mortality, LOS and short-term morbidity.
BACKGROUND:Acute kidney injury (AKI) in critically illchildren is associated with increased mortality and morbidity. In this study we evaluated the effect of AKI severity on the incidence of short-term mortality and morbidity. METHODS: Multicenter prospective cohort study was conducted over two years period. We used the Kidney Disease Improving Global Outcomes (KDIGO) to diagnose and stage AKI. RESULTS: A total of 511 out of 1367 included children (37.4%; 95% CI: 34.8-40.0) were diagnosed with AKI. They were categorized into three KDIGO stages: stage I (mild) in 47.5% (95% CI: 43.2-52.0), stage II (moderate) in 32.8% (95% CI: 28.8-37.1) and stage III (severe) in 19.7% (95% CI: 16.4-23.5). Stage II and III AKI had higher risk of mortality and longer length of stay (LOS) in hospital. Children with stage III AKI were more likely to require mechanical ventilation, referral to pediatric nephrology and discharge with abnormal creatinine level (above 100 uml\L). Hypervolemia, hypocalcemia, anemia, and acidosis were found to be independent risk factors of mortality. CONCLUSION: The extent of severity of AKI is directly associated with increased mortality, LOS and short-term morbidity.
Authors: Monika Miklaszewska; Przemysław Korohoda; Alina Sobczak; Anna Horbaczewska; Agata Filipiak; Katarzyna Zachwieja; Krzysztof Kobylarz; Marcin Tkaczyk; Dorota Drożdż; Jacek A Pietrzyk Journal: Kidney Blood Press Res Date: 2014-05-09 Impact factor: 2.687
Authors: Scott M Sutherland; John J Byrnes; Manish Kothari; Christopher A Longhurst; Sanjeev Dutta; Pablo Garcia; Stuart L Goldstein Journal: Clin J Am Soc Nephrol Date: 2015-02-03 Impact factor: 8.237
Authors: L Nelson Sanchez-Pinto; Stuart L Goldstein; James B Schneider; Robinder G Khemani Journal: Pediatr Crit Care Med Date: 2015-10 Impact factor: 3.624
Authors: Martin C J Kneyber; Mohammed I Hersi; Jos W R Twisk; Dick G Markhorst; Frans B Plötz Journal: Intensive Care Med Date: 2007-06-16 Impact factor: 17.440
Authors: Michael Zappitelli; Chirag R Parikh; Ayse Akcan-Arikan; Kimberley K Washburn; Brady S Moffett; Stuart L Goldstein Journal: Clin J Am Soc Nephrol Date: 2008-04-16 Impact factor: 8.237
Authors: Omar Alkandari; K Allen Eddington; Ayaz Hyder; France Gauvin; Thierry Ducruet; Ronald Gottesman; Véronique Phan; Michael Zappitelli Journal: Crit Care Date: 2011-06-10 Impact factor: 9.097
Authors: Areef Ishani; Jay L Xue; Jonathan Himmelfarb; Paul W Eggers; Paul L Kimmel; Bruce A Molitoris; Allan J Collins Journal: J Am Soc Nephrol Date: 2008-11-19 Impact factor: 14.978
Authors: Osama Y Safdar; Khalid A Alhasan; Mohamed A Shalaby; Norah Khathlan; Suleman A Al Rezgan; Amr S Albanna; Jameela A Kari Journal: BMC Nephrol Date: 2020-04-16 Impact factor: 2.388