Loading…

A snapshot of acute kidney injury in tertiary paediatric centres in the United Kingdom

The precise incidence of acute kidney injury (AKI) in the paediatric age group is unknown, partly due to the lack of a universally agreed definition in the past. We conducted this study to assess incidence of AKI among hospitalised children on World Kidney Day 2016. Cross-sectional study involving 8...

Full description

Saved in:
Bibliographic Details
Published in:Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2017-12, Vol.24 (12), p.1333-1334
Main Authors: Verghese, G.K., Oni, L., Milford, D.V., Holt, R.C.L.
Format: Article
Language:English
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The precise incidence of acute kidney injury (AKI) in the paediatric age group is unknown, partly due to the lack of a universally agreed definition in the past. We conducted this study to assess incidence of AKI among hospitalised children on World Kidney Day 2016. Cross-sectional study involving 8 tertiary paediatric centres across England, Scotland, Wales and Northern Ireland. Centres reported numbers of new cases of AKI on a single observation day, associated clinical features and follow-up data where available. Cases were defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) AKI definition. On the observation day, there were 1218 inpatients in 8 centres. Thirty-one children (2.5%) met the case definition for AKI. The majority of patients had no pre-existing, known risk factors for AKI (20/31, 65%), while the leading known risk factor was congenital heart disease (5/31, 15%). Most cases of AKI were hospital acquired (25/31, 81%). The leading contributory factors were: medications (13/31, 42%), hypotension/shock (10/31, 32%) and dehydration (10/31, 32%). AKI was subdivided according to severity: stage 1 (25/31, 81%), stage 2 (2/31, 6%) and stage 3 (4/31, 13%). Follow-up results at 7 days were available for all 31 cases. Renal replacement therapy was required in 2 cases (6%). Recovery from AKI at 7 days was: complete (18/31, 58%), incomplete (9/31, 29%) or unknown (4/31, 13%); 2 patients (6%) died from non-renal causes. This is the first study looking at the point incidence of AKI in hospitalised paediatric patients according to the KDIGO AKI classification. Our estimated point incidence of 2.5% is similar to international reports. The majority of cases were hospital acquired and the leading contributory factor was nephrotoxic medication, a significant modifiable factor. Further prospective studies will be necessary to evaluate the benefit of interventions designed to reduce the incidence of AKI in paediatrics.
ISSN:0929-693X
1769-664X
DOI:10.1016/j.arcped.2017.10.017