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Acute kidney diseases and disorders in children with bloodstream infection: frequency, predictors, and outcomes

Misaki Akiyama1, Kentaro Nishi2, Toshihiro Matsui3

  • 1Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan.

Pediatric Nephrology (Berlin, Germany)
|August 12, 2026
PubMed

Insights

Pediatric acute kidney diseases and disorders (AKD) affect a significant number of children with bloodstream infections (BSI). Younger age is a key predictor for AKD development, highlighting the need for early intervention in pediatric kidney care.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute kidney diseases and disorders (AKD) are kidney damage events lasting 7-90 days.
  • Data on AKD following bloodstream infections (BSI) in children are limited.
  • Understanding AKD in pediatric BSI is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the incidence and predictors of AKD in pediatric patients with BSI.
  • To compare outcomes between patients with AKD and those with acute kidney injury (AKI) without AKD.
  • To identify factors associated with AKD development in this population.

Main Methods:

  • Retrospective observational study of pediatric patients (<20 years) with BSI and kidney dysfunction.
  • Defined AKI (0-7 days) and AKD (7-90 days) using KDIGO/ADQI criteria.
  • Used logistic regression to identify predictors of AKD.

Main Results:

  • 41% (41/96) of pediatric patients with BSI-related kidney dysfunction developed AKD.
  • Younger age was independently associated with AKD (OR 0.91, P=0.046).
  • Patients with AKD experienced higher rates of death and major adverse kidney events.

Conclusions:

  • AKD is a significant complication in children with BSI, occurring even without meeting AKI criteria.
  • Younger age is a risk factor for AKD in pediatric BSI.
  • Further research is needed to optimize AKD management in pediatric BSI.
Abstract

Keywords:
Acute kidney diseaseAcute kidney injuryBacteremiaPediatricSepsis

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