Epidemiology and outcomes of community-acquired and hospital-acquired acute kidney injury in children and adolescents

Background Hospital-acquired acute kidney injury (HA-AKI) is associated with an increased risk of childhood mortality; however, only a few studies have addressed community-acquired AKI (CA-AKI). Methods AKI network classification was used to assess CA- and HA-AKI, 2010–2014. Patients with CA-AKI who...

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Published in:Pediatric research 2018-03, Vol.83 (3), p.622-629
Main Authors: Hsu, Chien-Ning, Chen, Hsiao-Ling, Tain, You-Lin
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Language:English
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692/499
692/699/1585/4
692/700/1720/3187
692/700/478/174
Children & youth
Clinical outcomes
clinical-investigation
Epidemiology
Kidney diseases
Kidneys
Medicine
Medicine & Public Health
Mortality
Patient admissions
Pediatric Surgery
Pediatrics
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creator Hsu, Chien-Ning
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description Background Hospital-acquired acute kidney injury (HA-AKI) is associated with an increased risk of childhood mortality; however, only a few studies have addressed community-acquired AKI (CA-AKI). Methods AKI network classification was used to assess CA- and HA-AKI, 2010–2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, and in-hospital outcomes were assessed for variation. Results Prevalence of CANA-AKI was 4/1,000 outpatient visits, 17/1,000 hospital admissions for CAA-AKI, and 9.69/1,000 hospital admissions for HA-AKI. Mortality was higher among AKI patients (HA-AKI, 13.64%; CAA-AKI, 3.7%) than in no-AKI patients (0.57%). Patients with AKI and those with severe stages of AKI resulted in an increase in health-care service utilization (both P
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Methods AKI network classification was used to assess CA- and HA-AKI, 2010–2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, and in-hospital outcomes were assessed for variation. Results Prevalence of CANA-AKI was 4/1,000 outpatient visits, 17/1,000 hospital admissions for CAA-AKI, and 9.69/1,000 hospital admissions for HA-AKI. Mortality was higher among AKI patients (HA-AKI, 13.64%; CAA-AKI, 3.7%) than in no-AKI patients (0.57%). Patients with AKI and those with severe stages of AKI resulted in an increase in health-care service utilization (both P &lt;0.001). Prior renal disease and recent hospitalization were associated with pediatric AKI in both outpatient and inpatient settings. Hematological malignancies, congenital anomalies, circulatory disease, and nephrotoxic medication use were associated with AKI, although the extent of associations varied slightly by setting. Conclusion Increasing incidence of AKI in the community emphasizes the need for an increased awareness of AKI among health professionals to identify at-risk children and monitor SCr, so that modifiable risk factors can be managed.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/pr.2017.262</identifier><identifier>PMID: 29155805</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/499 ; 692/699/1585/4 ; 692/700/1720/3187 ; 692/700/478/174 ; Children &amp; youth ; Clinical outcomes ; clinical-investigation ; Epidemiology ; Kidney diseases ; Kidneys ; Medicine ; Medicine &amp; Public Health ; Mortality ; Patient admissions ; Pediatric Surgery ; Pediatrics</subject><ispartof>Pediatric research, 2018-03, Vol.83 (3), p.622-629</ispartof><rights>International Pediatric Research Foundation, Inc. 2018</rights><rights>Copyright Nature Publishing Group Mar 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-8b6cd6eaafe8c8397ed0b31a55bbe4d8d681f9f3c3e975fb0d5a4b3c8e06fad3</citedby><cites>FETCH-LOGICAL-c419t-8b6cd6eaafe8c8397ed0b31a55bbe4d8d681f9f3c3e975fb0d5a4b3c8e06fad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29155805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsu, Chien-Ning</creatorcontrib><creatorcontrib>Chen, Hsiao-Ling</creatorcontrib><creatorcontrib>Tain, You-Lin</creatorcontrib><title>Epidemiology and outcomes of community-acquired and hospital-acquired acute kidney injury in children and adolescents</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background Hospital-acquired acute kidney injury (HA-AKI) is associated with an increased risk of childhood mortality; however, only a few studies have addressed community-acquired AKI (CA-AKI). Methods AKI network classification was used to assess CA- and HA-AKI, 2010–2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, and in-hospital outcomes were assessed for variation. Results Prevalence of CANA-AKI was 4/1,000 outpatient visits, 17/1,000 hospital admissions for CAA-AKI, and 9.69/1,000 hospital admissions for HA-AKI. Mortality was higher among AKI patients (HA-AKI, 13.64%; CAA-AKI, 3.7%) than in no-AKI patients (0.57%). Patients with AKI and those with severe stages of AKI resulted in an increase in health-care service utilization (both P &lt;0.001). Prior renal disease and recent hospitalization were associated with pediatric AKI in both outpatient and inpatient settings. Hematological malignancies, congenital anomalies, circulatory disease, and nephrotoxic medication use were associated with AKI, although the extent of associations varied slightly by setting. 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Methods AKI network classification was used to assess CA- and HA-AKI, 2010–2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, and in-hospital outcomes were assessed for variation. Results Prevalence of CANA-AKI was 4/1,000 outpatient visits, 17/1,000 hospital admissions for CAA-AKI, and 9.69/1,000 hospital admissions for HA-AKI. Mortality was higher among AKI patients (HA-AKI, 13.64%; CAA-AKI, 3.7%) than in no-AKI patients (0.57%). Patients with AKI and those with severe stages of AKI resulted in an increase in health-care service utilization (both P &lt;0.001). Prior renal disease and recent hospitalization were associated with pediatric AKI in both outpatient and inpatient settings. Hematological malignancies, congenital anomalies, circulatory disease, and nephrotoxic medication use were associated with AKI, although the extent of associations varied slightly by setting. Conclusion Increasing incidence of AKI in the community emphasizes the need for an increased awareness of AKI among health professionals to identify at-risk children and monitor SCr, so that modifiable risk factors can be managed.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>29155805</pmid><doi>10.1038/pr.2017.262</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects 692/499
692/699/1585/4
692/700/1720/3187
692/700/478/174
Children & youth
Clinical outcomes
clinical-investigation
Epidemiology
Kidney diseases
Kidneys
Medicine
Medicine & Public Health
Mortality
Patient admissions
Pediatric Surgery
Pediatrics
title Epidemiology and outcomes of community-acquired and hospital-acquired acute kidney injury in children and adolescents
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