Factors that influenced undergoing renal replacement therapy and survival in children with acute kidney injury. Issue 2 (29th January 2019) - Oztek‐Celebi, Fatma Z
ABSTRACT: Aim: Acute kidney injury (AKI) is an important clinical condition that is associated with increased mortality and morbidity. This study was performed to identify the factors that influence AKI stage, undergoing renal replacement therapy (RRT) and mortality. Methods: This study was retrospectively conducted on 219 children with AKI who had been referred to the paediatric nephrology division of Dr Sami Ulus Teaching Hospital during their inpatient treatment from 2008 to 2012. AKI was defined using pRIFLE criteria. Results: From the 219 enrolled patients, 131 were identified as having AKI at the time of hospital admission. Infant age group was the largest group. RRT was performed in 68 patients. Median RRT initiation time was 1.5 day (0–2) and the mortality increased significantly when RRT initiation time was >1 day. The likelihood of undergoing RRT was higher for patients who were younger, who were managed in PICU and who had intrinsic type of AKI. pRIFLE stage and AKI place did not influence the likelihood of undergoing RRT. Overall mortality was 26.9%. In log‐rank tests, factors influencing survival were younger age, being treated in PICU, developing AKI during inpatient treatment, having a comorbid condition and undergoing RRT. pRIFLE stage did not influence survival. In the logistic regression model, factors associated with mortality included younger age, undergoing RRT and having AKI during inpatient treatment. Having underlying disease and being managed in PICU did not influence the likelihood of death. Conclusion: Acute kidney injury is an important condition in all hospitalized patients. More studies and interventions are needed on this topic to identify, treat and prevent AKI. Summary at a Glance: AKI is a severe condition with high morbidity and mortality in hospitalized paediatric patients. From this study in AKI children, younger patients and those who had particular types of AKI were more likely to undergo RRT. It reinforces the need for research efforts in paediatric AKI and new strategies for early AKI detection and prevention.