Sepsis-Associated Acute Kidney Injury in the Paediatric Intensive Care Unit: Frequency and Outcomes

Area of Science:

• Pediatric critical care medicine
• Nephrology
• Infectious diseases

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• Acute kidney injury (AKI) is a common complication in critically ill children, particularly those with sepsis.
• Sepsis-associated AKI (S-AKI) presents unique challenges in diagnosis and management within the pediatric intensive care unit (PICU) setting.

Purpose of the Study:

• To determine the incidence and short-term outcomes of pediatric patients diagnosed with S-AKI.
• To analyze factors associated with the development of S-AKI in a PICU population.
• To evaluate the impact of S-AKI on length of PICU stay and mortality rates.

Main Methods:

• A cross-sectional study was conducted in a pediatric intensive care unit (PICU) from January 2021 to June 2022.
• Pediatric patients (1 month to 18 years) admitted with sepsis were assessed for AKI using the p-RIFLE criteria.
• Data analysis included Chi-square tests and logistic regression to identify associations between variables and S-AKI.

Main Results:

• Of 323 sepsis patients meeting inclusion criteria, 56 (17.3%) developed AKI.
• Patients with S-AKI experienced a longer mean PICU stay (7.04 days vs. 5.24 days) and higher mortality (39.22% vs. 20.59%).
• Hypotension, oliguria, elevated blood urea nitrogen (BUN), and metabolic acidosis were significantly associated with S-AKI.

Conclusions:

• Sepsis-associated AKI is a significant complication in the PICU, associated with adverse short-term outcomes.
• Children with S-AKI face prolonged PICU stays and a substantially increased risk of mortality.
• The findings underscore the importance of vigilant monitoring and prompt intervention for AKI in septic pediatric patients.