Pediatric Nephrology Center of Excellence, Pediatric Department, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
Pediatrics Department, College of Medicine. King Saud University, Riyadh, Kingdom of Saudi Arabia.
BMC Nephrol. 2019 Mar 12;20(1):89. doi: 10.1186/s12882-019-1278-1.
Acute kidney injury (AKI) in critically ill children is associated with increased mortality and morbidity. In this study we evaluated the effect of AKI severity on the incidence of short-term mortality and morbidity.
Multicenter prospective cohort study was conducted over two years period. We used the Kidney Disease Improving Global Outcomes (KDIGO) to diagnose and stage AKI.
A total of 511 out of 1367 included children (37.4%; 95% CI: 34.8-40.0) were diagnosed with AKI. They were categorized into three KDIGO stages: stage I (mild) in 47.5% (95% CI: 43.2-52.0), stage II (moderate) in 32.8% (95% CI: 28.8-37.1) and stage III (severe) in 19.7% (95% CI: 16.4-23.5). Stage II and III AKI had higher risk of mortality and longer length of stay (LOS) in hospital. Children with stage III AKI were more likely to require mechanical ventilation, referral to pediatric nephrology and discharge with abnormal creatinine level (above 100 uml\L). Hypervolemia, hypocalcemia, anemia, and acidosis were found to be independent risk factors of mortality.
The extent of severity of AKI is directly associated with increased mortality, LOS and short-term morbidity.
危重症患儿急性肾损伤（AKI）与死亡率和发病率增加相关。本研究评估了 AKI 严重程度对短期死亡率和发病率的影响。
本研究为两年期间的多中心前瞻性队列研究。我们使用肾脏疾病改善全球结局（KDIGO）标准诊断和分期 AKI。
在纳入的 1367 例患儿中，共有 511 例（37.4%；95%CI：34.8-40.0）被诊断为 AKI。他们被分为三个 KDIGO 分期：Ⅰ期（轻度）47.5%（95%CI：43.2-52.0），Ⅱ期（中度）32.8%（95%CI：28.8-37.1）和Ⅲ期（重度）19.7%（95%CI：16.4-23.5）。Ⅱ期和Ⅲ期 AKI 患儿的死亡率和住院时间（LOS）更长。Ⅲ期 AKI 患儿更可能需要机械通气、转至小儿肾病科和出院时肌酐水平异常（>100umol/L）。高容量血症、低钙血症、贫血和酸中毒是死亡的独立危险因素。
AKI 的严重程度与死亡率、LOS 和短期发病率增加直接相关。
