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Epidemiology data on the cost and outcomes associated with pediatric acute kidney injury

Rupesh Raina1,2, Sidharth Sethi3, Varun Aitharaju4

  • 1Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA. rraina@akronchildrens.org.

Pediatric Research
|March 23, 2023
PubMed

Insights

Hospitalized children with acute kidney injury (AKI) face higher mortality and longer hospital stays. This condition also significantly increases the need for mechanical ventilation and healthcare costs in pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Health Services Research

Background:

  • Hospitalized children with acute kidney injury (AKI) lack extensive study regarding clinical outcomes.
  • Previous research has not comprehensively evaluated the impact of pediatric AKI on hospital stay, mechanical ventilation, mortality, and healthcare utilization.
  • There is a hypothesis of significant financial costs and increased morbidity and mortality associated with pediatric AKI.

Purpose of the Study:

  • To investigate the clinical outcomes and healthcare utilization in hospitalized children diagnosed with acute kidney injury (AKI).
  • To quantify the association between pediatric AKI and key outcomes such as mortality, duration of hospital stay, mechanical ventilation, and total healthcare expenditure.
  • To provide novel epidemiologic data on pediatric AKI to inform the scientific community and improve understanding of prevention and outcomes.

Main Methods:

  • Retrospective study utilizing the Kids' Inpatient Database (KID).
  • Inclusion of pediatric patients (age ≤18 years) between January 1, 2016, and December 31, 2021.
  • Comparative analysis between cohorts of children with and without AKI to assess outcomes.

Main Results:

  • The study included 4842 children, with 2424 having AKI and 2418 without.
  • Children with AKI showed significantly higher odds of mortality (p=0.004) and mechanical ventilation (p<0.001).
  • Patients with AKI experienced significantly longer median hospital stays (p<0.001) and higher total costs (p<0.001) compared to those without AKI.

Conclusions:

  • Pediatric acute kidney injury (AKI) is associated with increased mortality, prolonged hospital stays, and greater need for mechanical ventilation.
  • Hospitalized children with AKI incur significantly higher healthcare expenditures.
  • This study provides crucial epidemiologic data to enhance understanding of pediatric AKI outcomes and inform future research and clinical practice.
Abstract

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