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Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study

Dennis Bailey1, Véronique Phan, Catherine Litalien

  • 1Service of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montréal, Canada.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|January 26, 2007
PubMed

Insights

Acute kidney injury in critically ill children is uncommon but significantly increases mortality. Key risk factors include thrombocytopenia, hypoxemia, and hypotension.

Area of Science:

  • Pediatric critical care medicine
  • Nephrology
  • Epidemiology

Background:

  • Acute kidney injury (AKI) is a critical condition in adult intensive care units.
  • Limited data exists on AKI in critically ill children.
  • Understanding AKI in pediatric intensive care units (PICUs) is crucial for improving outcomes.

Purpose of the Study:

  • To determine the incidence rate of AKI in a PICU.
  • To identify significant risk factors associated with AKI development in children.
  • To describe the clinical outcomes and mortality associated with AKI in the PICU.

Main Methods:

  • Prospective, descriptive study conducted in a tertiary PICU.
  • 1,047 consecutively admitted children were observed over one year.
  • AKI defined as a doubling of baseline serum creatinine.

Main Results:

  • The incidence of AKI in the PICU was 4.5%.
  • Common admission diagnoses included hemolytic uremic syndrome, oncologic pathologies, and cardiac surgery.
  • Significant risk factors identified: thrombocytopenia (OR 6.3), age >12 yrs (OR 4.9), hypoxemia (OR 3.2), hypotension (OR 3.0), and coagulopathy (OR 2.7).
  • Mortality was significantly higher in patients with AKI (29.6%) compared to those without (2.3%).

Conclusions:

  • AKI in the PICU, though not frequent, is associated with substantially increased mortality.
  • Multiple risk factors contribute to AKI, often present before PICU admission.
  • Further multi-center studies are warranted to validate these findings.
Abstract

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