Acute kidney injury in critically ill children: incidence and risk factors for mortality

作者：Mariel Martin Sandra; Balestracci Alejandro; Aprea Valeria; Bolasell Cecilia; Wainsztein Raquel; Debaisi Gustavo; Roson Gerardo

来源：Archivos Argentinos de Pediatria, 2013, 111(5): 412-417.

DOI：10.5546/aap.2013.412

• acute kidney injury
• intensive care
• incidence
• mortality

Introduction. Acute kidney injury is a common complication associated with an increase in mortality in children who require intensive care. The objective of this study was to determine the incidence of acute kidney injury and identify risk factors for mortality in critically ill patients hospitalized in our facility.
Patients and Methods. This was a prospective and observational study conducted at the Intensive Care Unit (ICU) of Hospital Pedro de Elizalde between 2005 and 2009. All patients with acute kidney injury were included, and those with chronic renal failure, prerenal acute kidney injury, hepatorenal syndrome, newborn infants, and postoperative cardiovascular surgery patients were excluded.
The sample was divided into survivors and deceased patients so as to identify risk factors for mortality using univariate and multivariate analyses, taking their clinical characteristics as predictive variable, and death at the ICU as the outcome variable.
Results. Out of 1496 patients, 66 developed acute kidney injury (4.4%). The cause was secondary in 72.8% of cases, and due to primary kidney disease in 27.2% of cases. Mortality rate was 44% (29 patients). The univariate analysis showed that the presence of anuria (p= 0.0003; OR: 7.01; 95% CI: 2.3-21.35) and the need of dialysis (p= 0.0009; OR: 6.35; 95% CI: 2.03-9.88) were significantly higher in deceased patients. The multiple regression analysis identified that the need of dialysis (p = 0.0002; OR: 5.94; 95% CI: 1.85-19.04) was an independent risk factor for mortality.
Conclusions. The incidence of acute kidney injury in critically ill children was 4.4%, and the need of dialysis was an independent predictor of mortality.

• 出版日期2013-10