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J Pediatr Intensive Care 2021; 10(04): 264-270
DOI: 10.1055/s-0040-1716577
Original Article

A Study of Acute Kidney Injury in a Tertiary Care Pediatric Intensive Care Unit

Akanksha C. Parikh 
1   Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
,
Milind S. Tullu 
1   Department of Pediatrics, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Abstract

The objective of this study was to calculate the incidence, severity, and risk factors for acute kidney injury (AKI) in a tertiary care pediatric intensive care unit (PICU). Also, to assess the impact of AKI and its varying severity on mortality and length of hospital and PICU stays. A prospective observational study was performed in children between 1 month and 12 years of age admitted to the PICU between July 1, 2013, and July 31, 2014 (13 months). The change in creatinine clearance was considered to diagnose and stage AKI according to pediatric risk, injury, failure, loss, and end-stage renal disease criteria. The risk factors for AKI and its impact on PICU stay, hospital stay, and mortality were evaluated. Of the total 220 patients enrolled in the study, 161 (73.2%) developed AKI, and 59 cases without AKI served as the “no AKI” (control) group. Majority (57.1%) of children with AKI had Failure grade of AKI, whereas 26.1% had Risk grade and 16.8% had Injury grade of AKI. Infancy (p = 0.000), hypovolemia (p = 0.005), shock (p = 0.008), and sepsis (p = 0.022) were found to be significant risk factors for AKI. Mortality, PICU stay, and hospital stay were comparable in children with and without AKI as well as between the various grades of renal injury (i.e., Failure, Risk, and Injury). An exceedingly high incidence of AKI, especially of the severe Failure grade was observed in critically ill children. Infancy and frequent PICU occurrences such as sepsis, hypovolemia, and shock predisposed to AKI.

Keywords

acute kidney injury - hospital stay - mortality - pediatric intensive care unit - pRIFLE criteria - renal - risk factors

Authors' Contributions

Akanksha C. Parikh and Milind S. Tullu were both involved in conceptualization of the manuscript and the project, collecting patient data and data analysis, conducting literature search, and drafting the manuscript. Both the authors are designated as First Authors of this manuscript. Milind S. Tullu will act as the corresponding author and the guarantor for the manuscript.




Publication History

Received: 26 May 2020

Accepted: 26 July 2020

Article published online:
11 September 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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