ESPN 53rd Annual Meeting

ESPN 2021


 
Risk Factors for Acute Kidney Injury in Pediatric Intensive Care Unit
KUBRA CELEGEN 1 MEHMET CELEGEN 2

1- AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, PEDIATRIC NEPHROLOGY DEPARTMENT
2- AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, PEDIATRIC INTENSIVE CARE UNIT
 
Introduction:

 Acute kidney injury (AKI) is one of the common risk factors for prolonged hospitalization and increased mortality in critically ill patients. The incidence of AKI  was reported as 26.9%. Underlying diseases, inotropic requirement, multi-organ failure, and the use of nephrotoxic treatments are associated with in-hospital AKI. In this study, we aimed to evaluate in-hospital AKI rate and risk factors for AKI. 

Material and methods:

All pediatric patients admitted to the intensive care unit between January-2020 and March-2021 were included. Patients with primary kidney disease and hospitalization 24 hours were excluded. Demographics, clinical features, treatments , PRISM II and PELOD scores were compared AKI and non-AKI group. Acute kidney injury (AKI) was defined based on KDIGO 2012 creatinine criteria.

Results:

142 patients were included to analyses. AKI was developed in 19 patients (13.3%)  during hospitalization median on 3.5 days. Six patients (31.6%) had stage 1, 7 patients (36.8%) stage 2, and 6 patients (31.6%) stage 3 AKI. AKI was more common in patients with sepsis (p <0.001)  and patients with a diagnosis of malignancy (p = 0.007).  Inotrope requirement, mechanical ventilation support, and PRISM II and PELOD scores were higher in AKI group. Mortality rate was higher in patients who developed AKI (p <0.001).Use of diuretics, vancomycin/aminoglycoside, blood products, and contrast agents was found to be significantly higher in AKI group. In the multivariate logistic regression analysis adjusted for PRISM II, sepsis and malignancy diagnoses, the use of diuretics (OR: 16.4; p = 0.007) and vancomycin/ aminoglycoside (OR: 10.5; p = 0.018) were remained their significance.

Conclusions:

 The use of diuretic and nephrotoxic antibiotics are independent risk factors for AKI in critically ill children. Preventive strategies such as drug blood level monitoring and avoiding redundant diuretics are necessary to reduce the risk of AKI and mortality.