Acute kidney injury and mortality in critically ill children

Putri Amelia; Munar Lubis; Ema Mutiara; Yunnie Trisnawati

doi:10.14238/pi54.5.2014.251-5

Putri Amelia Department of Child Health, University of North Sumatera Medical School/Haji Adam Malik Hospital
Munar Lubis Department of Child Health, University of North Sumatera Medical School/Haji Adam Malik Hospital
Ema Mutiara Department of Child Health, University of North Sumatera Medical School/Haji Adam Malik Hospital
Yunnie Trisnawati Department of Child Health, University of North Sumatera Medical School/Haji Adam Malik Hospital

DOI: https://doi.org/10.14238/pi54.5.2014.251-5

Keywords: acute kidney injury, critically ill, mortality

Abstract

Background Mortality from acute kidney injury (AKI) can be as
high as 60% in critically ill children. This high mortality rate is
influenced by the severity of primary diseases, organ dysfunction,
and the stage of acute kidney injury.
Objective To assess for an as sedation between AKI and mortality
in critically ill children hospitalized in the pediatric intensive care
unit (PICU).
Methods A cross-sectional study was conducted from April
to July 2012. All patients aged 1 month to 18 years who were
hospitalized in the PICU for more than 24 hours were included.
Urine output and serum creatinine levels were evaluated daily.
Patients were categorized according to the pediatric risk, injury,
failure, loss, and end stage renal disease (pRIFLE) criteria. Chi
square, Fisher's exact, Mann-\X'hitney U, and Kruskal-Wallis tests
were used to assess for an association between AKI, mortality,
pediatric logistic organ dysfunction (PELOD) score, and length
of PICU stay. AP value of < 0.05 was considered as statistically
significant.
Results During the study period, 57 children were admitted,
consisting of 25 (43.9%) females and 32 (56.1 %) males, with
a median age of 43 months. The prevalance of AKI was 31.5%
(18/57) and classified into stages: risk 13/18, injury 3/18, and
failure 2/18. The mortality rate for AKI was 16. 7%. There was no
association between AKI and mortality (P=0.592). The PELOD
scores were found to be similar among patients (SD 11.3 2 vs. SD
12.23; P=0.830), and there was no association between AKI and
length of PICU stay (P=0.819).
Conclusion There is no association between AKI and mortality
in critically ill children admitted in PICU.

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