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Acute Kidney Injury in Children With Acute Respiratory Failure

Sindy M Villacrés1,2, Shivanand S Medar1,2, Scott I Aydin1,2

  • 11 The Children's Hospital at Montefiore, Bronx, NY, USA.

Clinical Pediatrics
|June 9, 2018
PubMed

Insights

Acute kidney injury (AKI) is common in critically ill children with acute respiratory failure (ARF). Higher positive end-expiratory pressure and admission serum creatinine are key risk factors for AKI in this population.

Area of Science:

  • Pediatric critical care medicine
  • Nephrology
  • Pulmonology

Background:

  • Acute kidney injury (AKI) frequently complicates critical illness in children.
  • Acute respiratory failure (ARF) is a common co-occurring condition in critically ill children.
  • Understanding AKI in pediatric ARF is crucial for improving outcomes.

Purpose of the Study:

  • To investigate the incidence and risk factors of AKI in children with ARF.
  • To identify associations between AKI and clinical parameters in pediatric ARF patients.

Main Methods:

  • Retrospective analysis of pediatric intensive care unit (PICU) admissions for ARF (2010-2013).
  • Inclusion criteria: children aged 1 day to 18 years with ARF.
  • Statistical analyses included descriptive statistics and multivariate analyses to determine risk factors for AKI.

Main Results:

  • 53% of 186 pediatric ARF patients developed AKI.
  • AKI patients had higher serum creatinine and lower creatinine clearance.
  • Moderate to severe acute respiratory distress syndrome (ARDS) was associated with higher AKI rates (64% vs. 46%).
  • Positive end-expiratory pressure (PEEP) and admission serum creatinine were independent predictors of AKI.

Conclusions:

  • AKI is highly prevalent in children with ARF.
  • AKI in pediatric ARF is linked to ARDS, prolonged PICU, and hospital stays.
  • PEEP and admission serum creatinine are significant independent risk factors for AKI in pediatric ARF.
Abstract

Keywords:
critical carenephrologypulmonology

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