Complete Blood Cell and HCO3 as a Predictor of Developing Acute Kidney Injury in Children

Abstract

Background: Acute kidney injury (AKI) due to hypovolemia and gastroenteritis is still a common disease, especially among children in developing countries. The risk, injury, failure, loss, and end-stage renal disease (RIFLE) classification is used as the estimated indicator of outcomes and incidence of AKI. Leukocytosis may be seen with systemic infectious, inflammatory diseases, and pyelonephritis. However, the cell blood count is unspecific. Some studies have shown the role of complete blood count in AKI as a useful predictive factor for mortality. We aimed at investigating cell blood count indexes and HCO3 in the prognosis of children with RIFLE criteria of AKI. Methods: In this prospective study, 206 patients with AKI, who were admitted to Amir-Kabir emergency department, were investigated. The complete blood count, erythrocyte sedimentation rate, serum HCO3, and electrolytes of the patients were measured and compared. All patients were followed monthly for 4 months for renal function test and clinical manifestation. Data analysis was performed by SPSS Version 18 (IBM Corp., NY, US.). Mean, standard deviation, standard error, and frequency were used for descriptive analysis; and t-test, Chi-square, Mann-Whitney and Friedman tests were used for data analysis. Results: There were no significant differences between the 4 groups in white blood cell count, hemoglobin, hematocrit, and ESR at baseline (P > 0.05). The number of platelet units was remarkably higher, but the number of MPV and HCO3 was considerably lower in patients with loss/ failure criteria. Conclusions: MPV is higher in the case of platelets destruction, and this is commonly observed in inflammatory diseases. Metabolic acidosis is related to AKI and may lead to disorders such as hypotension, cardiac dysfunction, and mortality. HCO3, and MPV are likely to act as a predictor of the development of AKI. Conducting a multicenter study with a larger sample size and longer follow-up is suggested to examine the predictive factor of AKI.

Anuria in solitary kidney patient with gastroenteritis: A case report study

“…Sonography of the kidney and the urinary tract was done, and blood pressure was checked every hour. The treatment was done according to the initial management of children's acute renal failure (5,6). Based on the test results ( Afterward, the previous serum continued for 6 hours, and because of the high level of uric acid (9.5 mm/dc), allopurinol 18 mg was administered by gavage every 6 hours.…”