Al-Jboor Wejdan, Almardini Reham, Al Bderat Jwaher, Frehat Mahdi, Al Masri Hazem, Alajloni Mohammad Saleh
Pediatric Intensive Care Unit, Queen Rania Abdulla Children Hospital, Amman, Jordan.
Department of Pediatric Nephrology, Queen Rania Abdulla Children Hospital, Amman, Jordan.
Saudi J Kidney Dis Transpl. 2016 Jul-Aug;27(4):740-7. doi: 10.4103/1319-2442.185236.
Acute kidney injury (AKI) is a common and serious complication in patients in the Pediatric Intensive Care Unit (PICU). We conducted this study to estimate the incidence and the mortality rate of AKI in critically ill children as well as to describe some other related factors. A retrospective study was conducted at PICU of Queen Rania Abdulla Children Hospital, Amman, Jordan for the period extending from May 2011 to June 2013. The medical records of all patients admitted during this period, and their demographic data were reviewed. Patients with AKI were identified, and management and outcomes were reviewed and analyzed. AKI was evaluated according to modified RIFLE criteria. Of the 372 patients admitted to PICU, 64 (17.2%) patients developed AKI. Of these 64 patients who had AKI, 28 (43.7%) patients reached RIFLE max of risk, 21 (32.8%) patients reached injury, and 15 (23.4%) reached failure. Mean Pediatric Risk of Mortality II score at admission was significantly higher in patients with AKI than those without P <0.001. The age ranged between one month and 14 years with the median age as 5.4 year. Thirty-five (54.7%) were males. Sepsis was the most common cause of AKI. The mortality rate in critically ill children without AKI was 58.7%, whereas increased in children with AKI to 73.4%. The mortality rate in patients who received renal replacement therapy was 71.4% and was higher (81.5%) in patients who received mechanical ventilation (95%, [confidence interval (CI)] 79.3-83.4%) and was significantly higher in patients with multi-organ system dysfunction 90.3% (95%, [CI] 88.7-92.5%). The incidence of AKI in critically ill children is high and increased their mortality rate and higher mortality seen in the younger age group, especially those below one year. High mortality rate was associated with multi-organ system dysfunction and the need for mechanical ventilation.
急性肾损伤（AKI）是儿科重症监护病房（PICU）患者常见且严重的并发症。我们开展这项研究以评估危重症儿童中AKI的发病率和死亡率，并描述一些其他相关因素。在约旦安曼的拉尼亚·阿卜杜拉王后儿童医院的PICU进行了一项回顾性研究，研究时间段为2011年5月至2013年6月。回顾了该期间所有入院患者的病历及其人口统计学数据。确定了患有AKI的患者，并对其治疗和结局进行了回顾与分析。根据改良的RIFLE标准对AKI进行评估。在入住PICU的372例患者中，64例（17.2%）发生了AKI。在这64例患有AKI的患者中，28例（43.7%）达到RIFLE分级的最高风险级别，21例（32.8%）达到损伤级别，15例（23.4%）达到衰竭级别。AKI患者入院时的小儿死亡风险II评分均值显著高于无AKI的患者（P<0.001）。年龄范围在1个月至14岁之间，中位年龄为5.4岁。35例（54.7%）为男性。脓毒症是AKI最常见的病因。无AKI的危重症儿童死亡率为58.7%，而患有AKI的儿童死亡率增至73.4%。接受肾脏替代治疗的患者死亡率为71.4%，接受机械通气的患者死亡率更高（81.5%，[置信区间（CI）]79.3 - 83.4%），多器官系统功能障碍患者的死亡率显著更高，为90.3%（95%，[CI]88.7 - 92.5%）。危重症儿童中AKI的发病率较高，且增加了他们的死亡率，在较年轻年龄组尤其是1岁以下儿童中死亡率更高。高死亡率与多器官系统功能障碍及机械通气需求相关。
