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Pattern and prognostic factors for kidney function progression in survivors of children with acute kidney injury: a

Wun Fung Hui1, Vivian Pui Ying Chan2, Wing Lum Cheung3

  • 1Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon, Hong Kong huiwf@ha.org.hk.

Archives of Disease in Childhood
|January 18, 2024
PubMed

Insights

Acute kidney injury (AKI) and acute kidney disease (AKD) are common in critically ill children. These conditions significantly increase the risk of long-term kidney function problems in survivors.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Physiology

Background:

  • Acute kidney injury (AKI) is a significant concern in pediatric intensive care units (PICUs).
  • The long-term consequences of AKI, including the development of acute kidney disease (AKD), require further investigation.
  • Understanding kidney function progression after AKI is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the pattern of kidney function changes following acute kidney injury in children.
  • To identify risk factors associated with the progression of kidney dysfunction after AKI.
  • To determine the long-term renal outcomes in pediatric PICU survivors who experienced AKI and AKD.

Main Methods:

  • A prospective cohort study was conducted involving children aged 1 month to 18 years admitted to the PICU.
  • Acute kidney disease (AKD) was defined as AKI persisting between 7 and 90 days post-diagnosis.
  • Kidney function was monitored using estimated glomerular filtration rate (eGFR) and serum creatinine levels throughout the follow-up period.

Main Results:

  • The incidence of AKI was 41.9% and AKD was 52.2% among the 253 admissions.
  • A significant proportion of children (6.7% at 90 days, 11.9% at latest follow-up) had eGFR <90 mL/min/1.73 m².
  • Severe and prolonged AKI, along with exposure to nephrotoxic medications, were linked to AKD development and predicted poor kidney function recovery.

Conclusions:

  • Acute kidney injury and acute kidney disease are prevalent in critically ill children.
  • These conditions pose a substantial risk for non-recovery of kidney function in PICU survivors.
  • Regular follow-up for AKI survivors is recommended to monitor kidney function progression.
Abstract

Keywords:
epidemiologyintensive care units, paediatricnephrologypaediatrics

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