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

Abstract

Background Acute kidney injury (AKI) is a common problem
in hospitalized pediatric patients, with effects on morbidity and
mortality.
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
outcomes.