Pediatric Nephrology Center of Excellence, Department of Pediatrics, King Abdulaziz University, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
Pediatrics Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Pediatr Nephrol. 2018 Feb;33(2):335-340. doi: 10.1007/s00467-017-3786-1. Epub 2017 Sep 15.
Acute kidney injury (AKI) is a common problem encountered in critically ill children with an increasing incidence and evolving epidemiology. AKI carries a serious morbidity and mortality in patients requiring admission to a pediatric intensive care unit (PICU).
We undertook a prospective cohort study of PICU admissions at three tertiary care hospitals in the Kingdom of Saudi Arabia over 2 years. The Kidney Disease Improving Global Outcomes (KDIGO) definition was used to diagnose AKI.
A total of 1367 pediatrics PICU admissions were included in the study. AKI affected 511 children (37.4%), with 243 children (17.8%) classified as stage I (mild), 168 patients (12.3%) stage II (moderate), and 100 children (7.3%) were classified as stage III (severe). After adjustment for age, sex, and underlying diagnosis, in-hospital mortality was six times more likely among patients with AKI as compared to patients with normal renal function (adjusted OR: 6.5, 95% CI: 4.2-10). AKI was also a risk factor for hypertension (adjusted OR: 4.1, 95% CI: 2.8-5.9) and prolonged stay in the PICU and hospital, as it increased the average number of admission days by 10 (95% CI: 8.6-11) days in the PICU and 12 (95% CI: 10-14) days in the hospital.
One-third of PICU admissions were complicated with AKI. AKI was associated with increased hospital mortality and the length of stay in both PICU and hospital.
急性肾损伤（AKI）是危重症患儿中常见的问题，其发病率不断增加，发病情况也在不断演变。AKI 可导致入住儿科重症监护病房（PICU）的患者出现严重的发病率和死亡率。
我们对沙特阿拉伯三家三级保健医院的 PICU 住院患者进行了一项前瞻性队列研究。使用肾脏疾病：改善全球预后（KDIGO）定义来诊断 AKI。
共有 1367 例儿科 PICU 住院患者纳入本研究。AKI 影响了 511 名儿童（37.4%），其中 243 名儿童（17.8%）为 I 期（轻度），168 名患者（12.3%）为 II 期（中度），100 名儿童（7.3%）为 III 期（重度）。在校正年龄、性别和基础诊断后，与肾功能正常的患者相比，AKI 患者的院内死亡率高 6 倍（校正 OR：6.5，95%CI：4.2-10）。AKI 也是高血压的危险因素（校正 OR：4.1，95%CI：2.8-5.9），并延长了 PICU 和医院的住院时间，因为它使 PICU 住院天数平均增加了 10 天（95%CI：8.6-11），医院住院天数增加了 12 天（95%CI：10-14）。
三分之一的 PICU 住院患者并发 AKI。AKI 与医院死亡率增加和 PICU 及医院住院时间延长相关。
