Pokrajac Danka, Hadžimuratović Admir, Kalkan Ismeta, Hadžimuratović Emina, Mišanović Verica, Anić Duško, Mustajbegović-Pripoljac Aida
Paediatric Clinic, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Med Glas (Zenica). 2023 Feb 1;20(1). doi: 10.17392/1562-22.
Aim To determine an outcome of acute kidney injury (AKI) in critically ill children (CIC) who needed renal replacement therapy (RRT) and were admitted to the Paediatric and Neonatal Intensive Care Unit (PICU and NICU) at the Paediatric Clinic, University Clinical Centre Sarajevo (UCCS). Methods The research included 81 children with AKI. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define AKI was used. Other laboratory findings and imaging tests were made depending on children's primary disease that led to the AKI. Results Among 81 children with AKI, 38 were girls and 43 boys. A total of 39 (48.1%) patients died; the death was due to the nature of the primary disease and multiple organ failure syndromes. Out of the total of 81 patients the highest mortality rate was found in children in the first year of life, 22 (56.4%), while 17 (43.6%) patients died after the first year of life. Conclusion Without an accurate diagnosis at the right time, due to the lack of adequate biomarkers for AKI screening, the heterogeneity of AKI, comorbidities often lead to unfavourable outcomes of the disease, among CIC, especially in infants with low birth weight and extreme immaturity. Some causes of AKI are preventable and can be reduced by a better organization of primary and secondary health care.
目的 确定在萨拉热窝大学临床中心儿科诊所的儿科和新生儿重症监护病房(PICU和NICU)接受肾脏替代治疗(RRT)的危重症儿童(CIC)中急性肾损伤(AKI)的预后。方法 该研究纳入了81例AKI患儿。采用改善全球肾脏病预后组织(KDIGO)制定的AKI诊断标准。根据导致AKI的患儿原发性疾病进行其他实验室检查和影像学检查。结果 在81例AKI患儿中,女孩38例,男孩43例。共有39例(48.1%)患者死亡;死亡原因是原发性疾病的性质和多器官功能衰竭综合征。在81例患者中,1岁以下儿童的死亡率最高,为22例(56.4%),而1岁以后有17例(43.6%)患者死亡。结论 由于缺乏用于AKI筛查的适当生物标志物、AKI的异质性以及合并症,在危重症儿童中,尤其是低出生体重和极度不成熟的婴儿中,如果不能及时进行准确诊断,往往会导致疾病的不良预后。AKI的一些病因是可以预防的,通过更好地组织初级和二级卫生保健可以减少这些病因。