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Hyperglycemia and acute kidney injury in critically ill children

Roberto Gordillo1, Tania Ahluwalia2, Robert Woroniecki3

  • 1Department of Pediatrics, Division of Nephrology.

International Journal of Nephrology and Renovascular Disease
|September 8, 2016
PubMed

Insights

Hyperglycemia in critically ill children is linked to acute kidney injury (AKI) and extended pediatric intensive care unit (PICU) stays. This study highlights the association between high blood sugar and kidney complications in pediatric patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nephrology
  • Endocrinology

Background:

  • Hyperglycemia and acute kidney injury (AKI) are prevalent in critically ill children, contributing to increased morbidity and mortality.
  • Defining AKI in children is challenging due to the lack of a standardized definition, although pediatric RIFLE criteria exist.
  • The relationship between hyperglycemia and AKI in pediatric intensive care unit (PICU) patients requires further investigation.

Purpose of the Study:

  • To evaluate the impact of hyperglycemia on kidney function in critically ill children.
  • To assess the association between hyperglycemia and acute kidney injury (AKI).
  • To examine the effect of hyperglycemia on neutrophil gelatinase-associated lipocalin (NGAL) levels in pediatric patients.

Main Methods:

  • Retrospective and prospective cohorts of pediatric critically ill patients admitted to the PICU were analyzed.
  • Data collected included estimated glomerular filtration rate, plasma and urine NGAL, serum glucose, peak glycemia, and length of hospital and PICU stay.
  • Statistical analyses were performed to determine associations between hyperglycemia, AKI, NGAL levels, and patient outcomes.

Main Results:

  • Hyperglycemia was highly prevalent (89% retrospective, 86% prospective).
  • Acute kidney injury (AKI) was significantly associated with peak glycemia (P=0.03).
  • Peak glycemia correlated significantly with longer hospital and PICU stays (P<0.001 for both).
  • Urine and plasma NGAL levels did not differ significantly between hyperglycemic and normoglycemic children.
  • Patients on vasopressors exhibited lower estimated glomerular filtration rate and higher glycemia (P=0.01 and P=0.04, respectively).

Conclusions:

  • Hyperglycemia is a significant factor associated with acute kidney injury (AKI) in critically ill children.
  • Elevated blood glucose levels in pediatric patients correlate with prolonged PICU stays.
  • Further research may explore targeted interventions for hyperglycemia to mitigate AKI risk and improve outcomes in critically ill children.
Abstract

Keywords:
AKINGALPICUeGFRhyperglycemiapeak glycemia

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