Outcomes of acute kidney injury in children at Muhammad Husin Hospital, Palembang

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Hertanti lndah Lestari
Dahler Bahrun
Eka lntan Fitriana


Background Acute kidney injury (AKI) is a common problem
in hospitalized pediatric patients, with effects on morbidity and
Objectives To assess for the incidence and common etiologies of
AKI, as well as to review factors that affect patient outcomes at
Muhammad Husin Hospital, Palembang.
Methods We reviewed data from our nephrology registry from
January 2010 to June 2013. Independent variables were age, stage
and etiology of AKI, requirement of renal replacement therapy
(RRT) , and PICU admission. The dependent variable was patient
outcomes, categorized as survived or died. Association between
clinical data and outcomes were analyzed by Chi-square test.
Results The incidence of AKI was 28.3%. Using the pediatric risk,
injury, failure, loss, end stage renal disease (pRIFLE) criteria, 65
(36.7%) patients were in the risk stage, 56 (31.6%) in the injury
stage, and 56 (31.6%) in the failure stage. Twelve (6.8%) patients
required RRT and 29 (16.4%) patients were admitted to the PIW.
The mortality rate from AKI was 20.9%. The common etiologies of
AKI were acute glomerulonephritis (55 subjects; 31.1 % ), multiple
organ dysfunction (24 subjects; 13.6%), dehydration (23 subjects;
13.0%), hypoalbuminemia (20 subjects; 11.3%), heart failure (11
subjects; 6.2%) and nephrotoxic agents (12 subjects; 6.8%) . The
mortality rate was significantly higher in children of younger age
(<5 years) (P=0.0001), in the failure stage of AKI (P=0.014),
with non-renal origin of illness (P=0.0001) and those with an
indication for PIW admission (P=0.0001).
Conclusion AKI is found in one-third of nephrology patients.
The most common etiology of AKI is acute glomerulonephritis.
One-fifth of patients with AKI do not survive. Recognition ofrisk
factors and detection of AKI in early stages might improve patient

Article Details

How to Cite
Lestari H, Bahrun D, Fitriana E. Outcomes of acute kidney injury in children at Muhammad Husin Hospital, Palembang. PI [Internet]. 30Oct.2014 [cited 29Feb.2020];54(5):266-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/703
Received 2016-09-26
Accepted 2016-09-26
Published 2014-10-30


1. Zappitelli M, Parikh CR, Akcan-Arikan A, Washburn KK, Moffett BS, Golds tein SL. Ascertainment and epidemiology of acute kidney injury varies with definition interpretation. Clin J Am Soc Nephrol. 2008;3:948-54.
2. Bellomo R, Ronco, C, Kellum JA, Mehta RL, Palevsky P, Acute Dialysis Quality Initiative Workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conferences of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204-12.
3. Bresolin N, Silva C, Halilal A, Toporovski J, Fernandes V, Goes J, et al. Prognosis for children with acute kidney injury in the intensive care unit. Pediatr Nephrol. 2009;24:537-44.
4. Waikar SS, Liu KD, Chertow GM. Diagnosis, epidemiology and outcomes of acute kidney injury. Clin J Am Soc Nephrol. 2008;3:844-61.
5. Saragih RA, Mandei JM, Yuniar I, Dewi R, Pardede SO, Pudjiadi A, et al. Using pRIFLE criteria for acute kidney injury in critically ill children. Paediatr Indones. 2013;53:32-6.
6. Ricci Z, Cruz D, Ronco C. The RIFLE criteria and mortality in acute kidney injury: a systematic review. Kidney Int. 2008;73:538-46.
7. Hui WF, Chan WK, Miu TY. Acute kidney injury in the paediatric intensive care unit: identification by modified RIFLE criteria. Hong Kong Med J. 2013;19:13-9.
8. Andreoli SP. Acute kidney injury in children. Pediatr Nephrol. 2009;24:253-63.
9. Goldstein SL, Zappitlli M. Management of acute kidney failure. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N, editors. Pediatric nephrology. 6th ed. Berlin: Springer-Verlag Berlin Heidelberg; 2009. p. 1619-28.
10. Sutherland SM, Ji J, Sheiki FH, Widen E, Tian L, Alexander SR, et al. AKI in hospitalized children: epidemiology and clinical associations in a national cohort. Clin J Am Soc Nephrol. 2013;8:1661-9.
11. Vachvanichsanong P, Dissaneewate P, Lim A, McNeil E. Childhood acute renal failure: 22-year experience in a university hospital in southern Thailand. Pediatrics. 2006;118:e786-91.
12. Andreoli SP. Clinical evaluation of acute kidney injury in children. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N, editors. Pediatric nephrology. 6th ed. Berlin: Springer-Verlag Berlin Heidelberg; 2009. p. 1603-15.
13. William DM, Sreedhar SS, Mickell JJ, Chan JC. Acute kidney failure: a pediatric experience over 20 years. Arch Pediatr Adolesc Med. 2002;156:893-900.
14. Pundziene B, Dobiliene D, Rudaitis S. Acute kidney injury in pediatric patients: experience of a single center during an 11-year period. Medicina. 2010;46:511-5.
15. Esezobor CI, Ladapo TA, Osinaike B, Lesi FE. Paediatric acute kidney injury in a tertiary hospital in Nigeria: prevalence, causes and mortality rate. PLoS One. 2012;7:e51229.
16. Bhattacharya M, Dhingra D, Mantan M, Upare S, Sethi GR. Acute renal failure in children in a tertiary care center. Saudi J Kidney Dis Transpl. 2013;24:413-7.
17. Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W, Macleod A. Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol. 2007;18:1292-8.
18. Rivero MA, Padola NL, Etcheverria AI, Parma AE. Enterohemorrhagic Escherichia coli and hemolytic-uremic syndrome in Argentina. Medicina (B Aires). 2004;64:352-6.
19. Cerda J, Lameire N, Eggers P, Pannu N, Uchino S, Wang H, et al. Epidemiology of acute kidney injury. Clin J Am Soc Nephrol. 2008;3:881-6.
20. Khakurel S, Satyal PR, Agrawal RK, Chhetri PK, Hada R. Acute renal failure in a tertiary care center in Nepal. J Nepal Med Assoc. 2005;44:32-5.
21. Bahloul M, Ben Hamida C, Damak H, Kallel H, Ksibi H, Rekik N, Chelly H, Bouaziz M. Incidence and prognosis of acute renal failure in the intensive care unit. Retrospective study of 216 cases. Tunis Med. 2003;81:250-7.