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Etiology and Outcome of Community-Acquired Acute Kidney Injury in Pediatric Inpatients

Ashna Ashish1, Manish Kumar2, Kirtisudha Mishra1

  • 1Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Delhi.

Indian Pediatrics
|May 22, 2023
PubMed

Insights

Community-acquired acute kidney injury (CA-AKI) affects 7.7% of hospitalized children, often caused by dehydration or sepsis. CA-AKI increases the risk of chronic kidney disease (CKD), particularly if renal recovery is incomplete.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Epidemiology

Background:

  • Community-acquired acute kidney injury (CA-AKI) is a significant concern in hospitalized children.
  • Understanding its causes, outcomes, and mortality risk factors is crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence, etiology, and outcomes of CA-AKI in hospitalized children.
  • To identify risk factors associated with mortality in pediatric CA-AKI cases.

Main Methods:

  • Prospective enrollment of 2780 children aged 2 months to 12 years hospitalized between October 2020 and December 2021.
  • CA-AKI diagnosis based on elevated serum creatinine at admission with subsequent improvement during hospitalization.
  • Data collection included etiology, treatment, renal recovery, and mortality.

Main Results:

  • CA-AKI incidence was 7.7% (215/2780 children).
  • Diarrhea with dehydration (39%) and sepsis (28%) were primary causes.
  • Mortality was 11% (24/215), with inotrope requirement as an independent predictor.
  • 88% achieved complete renal recovery, but 10/22 with incomplete recovery progressed to chronic kidney disease (CKD), including 3 requiring dialysis.

Conclusions:

  • CA-AKI is a common and serious condition in hospitalized children.
  • Incomplete renal recovery post-CA-AKI is linked to a higher risk of progressing to CKD.
Abstract

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