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Community-Based Epidemiology of Hospitalized Acute Kidney Injury

Rishi V Parikh1, Thida C Tan1, Anne S Salyer2

  • 1Division of Research, Kaiser Permanente Northern California, Oakland, California.

Pediatrics
|August 14, 2020
PubMed

Insights

Pediatric acute kidney injury (AKI) affects about 1 in 1000 children annually, often occurring outside the ICU. Many children with AKI do not receive timely follow-up kidney function testing after hospitalization.

Area of Science:

  • Pediatric Nephrology
  • Epidemiology
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) in children can have lasting health effects.
  • Population-level data on pediatric AKI, especially outside intensive care units (ICUs), is limited.

Purpose of the Study:

  • To determine the incidence of hospitalized AKI in a large pediatric population.
  • To assess the proportion of AKI cases occurring outside ICUs.
  • To evaluate follow-up kidney function testing rates after pediatric AKI hospitalization.

Main Methods:

  • Analysis of a large, diverse pediatric cohort (2008-2016) within an integrated healthcare system.
  • Calculation of age- and sex-adjusted AKI incidence using consensus serum creatinine criteria.
  • Investigation of AKI detection in non-ICU settings and outpatient follow-up testing rates.

Main Results:

  • The overall incidence of hospitalized pediatric AKI was approximately 0.70 per 1000 person-years.
  • The incidence of AKI among hospitalized children increased from 6.0% to 8.8% between 2008 and 2016.
  • Two-thirds of AKI episodes occurred outside the ICU, and over half of unresolved AKI cases lacked follow-up testing within 30 days.

Conclusions:

  • Community-based pediatric AKI incidence is about 1 per 1000 child-years.
  • A significant proportion of pediatric AKI occurs outside the ICU and is not followed by adequate kidney function monitoring.
  • Improved recognition and targeted post-discharge monitoring are crucial for managing pediatric AKI.
Abstract

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