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Acute kidney failure: a pediatric experience over 20 years
Debra M Williams1, Sue S Sreedhar, John J Mickell
1Department of Pediatrics, Virginia Commonwealth University, Richmond, USA.
Archives of Pediatrics & Adolescent Medicine
|August 29, 2002
Summary
Pediatric acute kidney failure remains a critical condition. Survival rates are 73%, with cardiac repair complications and multiple organ failures significantly impacting mortality, alongside low serum albumin levels.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Renal Replacement Therapy
Background:
- Acute kidney failure (AKF) in children is a severe, life-threatening condition.
- Understanding trends in pediatric AKF is crucial for improving outcomes.
Purpose of the Study:
- To analyze two decades of pediatric AKF data.
- To compare causes, organ failures, and dialysis outcomes over time.
- To identify key risk factors for mortality in pediatric AKF.
Main Methods:
- Retrospective analysis of clinical data from 1979-1998.
- Inclusion of 228 pediatric patients (1 day-18 years) with AKF.
- Examination of mortality, ICU admission, procedures, and causes of AKF.
Main Results:
- Overall survival rate was 73% over the two decades.
- Hematologic-oncologic complications and pulmonary failure replaced sepsis and burns as leading causes in the second decade.
- 41% of patients underwent 106 acute extracorporeal procedures, including dialysis and hemofiltration.
Conclusions:
- Acute kidney failure post-cardiac repair remains a primary mortality risk.
- Failure of three organ systems is associated with >50% mortality.
- Low predialysis serum albumin is a significant predictor of mortality in pediatric AKF.
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