Restrepo de Rovetto Consuelo, Mora Julián A, Alexandre Cardona Sergio, Marmolejo Andrés F, Paz Juan F, de Castaño Iris
Departamento de Pediatría, Escuela de Medicina, Facultad de Salud, Universidad del Valle. Cali, Valle del Cauca, Colombia. E-mail:
Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Valle del Cauca, Colombia. E-mail:
Colomb Med (Cali). 2012 Sep 25;43(3):200-5. eCollection 2012 Jul.
To know the epidemiology of Acute Kidney Injury (AKI) in the pediatric population at Hospital Universitario del Valle (HUV), a tertiary University Hospital in Cali, Colombia.
We obtained a series of cases through daily surveillance for a seven-month period (June 1 to December 31, 2009) in patients older than 30 days and under 18 years at HUV. We excluded patients with previous diagnosis of chronic renal failure. The new pRIFLE scale was used to define AKI.
27 patients were detected, with mean age of 36 months. Incidence of AKI was 0.38% from pediatric admissions and 6.2% from the pediatric intensive care unit (pICU) admissions. The pRIFLE scale at study entrance was: Risk: 2 patients, Injury: 8, Failure: 17. Etiology of AKI was: pre-renal in 89%, primary renal disease in 3.7%, and post-renal in 7.4%. There was an association of AKI with sepsis in 66.7% and 48.2% progressed to septic shock. Six patients required renal replacement therapy, all required peritoneal dialysis. The AKI was multi-factorial in 59.3% and associated with systemic multi-organ failure in 59.3%. At study entry, 63% patients were in pICU. The average hospital stay was 21.3 ± 9.2 days. Six children died, 16 resolved AKI, and nine were left with renal sequelae.
We recommended pRIFLE scale for early diagnosis of AKI in all pediatric services. Education in pRIFLE scale, prevention of AKI, and early management of sepsis and hypovolemia is recommended.
了解位于哥伦比亚卡利的一家三级大学医院——巴耶大学医院（HUV）儿科人群中急性肾损伤（AKI）的流行病学情况。
我们通过对2009年6月1日至12月31日这七个月期间HUV中30天以上、18岁以下患者进行每日监测获得了一系列病例。我们排除了先前诊断为慢性肾衰竭的患者。采用新的pRIFLE标准来定义AKI。
共检测到27例患者，平均年龄为36个月。AKI在儿科入院患者中的发生率为0.38%，在儿科重症监护病房（pICU）入院患者中的发生率为6.2%。研究开始时pRIFLE标准分级情况为：风险期：2例患者，损伤期：8例，衰竭期：17例。AKI的病因如下：肾前性占89%，原发性肾脏疾病占3.7%，肾后性占7.4%。66.7%的AKI与脓毒症相关，其中48.2%进展为感染性休克。6例患者需要肾脏替代治疗，均需腹膜透析。59.3%的AKI为多因素导致，59.3%与全身多器官功能衰竭相关。研究开始时，63%的患者在pICU。平均住院时间为21.3±9.2天。6名儿童死亡，16例AKI得到缓解，9例遗留肾脏后遗症。
我们建议在所有儿科科室采用pRIFLE标准对AKI进行早期诊断。建议开展pRIFLE标准相关教育、预防AKI以及对脓毒症和血容量不足进行早期管理。
