The Prognostic Value of Inflammatory Markers in Paediatric Acute Kidney Injury

Background/Objectives: Acute kidney injury (AKI) is common in children. Several inflammatory markers proved their utility in predicting AKI, especially in adults, but their utility in children's populations is still under debate. Methods: We performed an observational retrospective cohort study on children admitted to the "Louis Turcanu" Emergency County Hospital for Children from Timisoara, Romania. We evaluated the utility of procalcitonin, C reactive protein, lactate dehydrogenase, ferritin, interleukin 6, albumins and erythrocyte sedimentation rate in predicting AKI and mortality in children. Results: The final cohort consisted of 131 children. The incidence of AKI was 39.6%, with more than half (61.1%) admitted in the intensive care unit. Out of twelve deaths, 11 were encountered in the AKI group. Patients from the AKI group presented higher levels of several inflammatory markers: lactate dehydrogenase, C reactive protein, procalcitonin, LDH, CRP, PCT and ferritin and lower albumins. Only ferritin, C reactive protein and procalcitonin could predict AKI development. Procalcitonin seems to increase mortality, but in the adjusted regression model, only AKI increased mortality. AKI increased mortality by 4.11 times (95%CI = 1.07-15.66, p = 0.038). Conclusions: Procalcitonin, C reactive protein, and ferritin proved to be predictors of AKI, yet none of the inflammatory markers influenced mortality. AKI is still an important independent mortality factor regardless of the underlying disease spectrum.