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Clinical Profile and Outcome of Emergencies in Pediatric Chronic Kidney Disease

Mohammed Azarudeen1, Nivedita Kamath2, A V Lalitha3

  • 1Department of Pediatric Nephrology, St John's Medical College Hospital, Bengaluru, Karnataka.

Indian Pediatrics
|August 2, 2021
PubMed

Insights

Emergencies in children with chronic kidney disease (CKD) often involve uremic encephalopathy or infections. Children with incidentally diagnosed CKD face worse outcomes and higher mortality risks.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Medicine

Background:

  • Chronic kidney disease (CKD) in children presents unique challenges.
  • Acute emergencies can significantly impact patient outcomes.
  • Understanding emergency profiles is crucial for timely intervention.

Purpose of the Study:

  • To delineate the clinical characteristics and outcomes of pediatric patients experiencing acute emergencies related to CKD.
  • To compare emergency presentations and outcomes across different stages of CKD: incidentally diagnosed (iCKD), previously diagnosed non-dialysis (pCKD), and maintenance dialysis (dCKD).

Main Methods:

  • Retrospective analysis of children with CKD presenting with acute emergencies.
  • Comparison of clinical profiles, renal function, and patient outcomes between iCKD, pCKD, and dCKD groups.

Main Results:

  • 82 children (median age 8 years) with 99 emergency visits were analyzed.
  • Uremic encephalopathy was the primary emergency in iCKD and pCKD, while access-related infections dominated in dCKD.
  • Children with iCKD exhibited higher Pediatric Risk of Mortality scores, more emergent dialysis initiation, and increased treatment discontinuation compared to pCKD.

Conclusions:

  • Uremic encephalopathy and access-related infections are the most frequent emergencies in pediatric CKD.
  • Children with incidentally diagnosed CKD present with a more severe clinical profile and poorer outcomes.
Abstract

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