Epidemiology and Outcome of Acute Kidney Injury According to Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease and Kidney Disease: Improving Global Outcomes Criteria in Critically Ill Children—A Prospective Study*

Volpon, Leila Costa; Sugo, E. K.; Consulin, J. C.; Tavares, T. L. G.; Aragon, Davi Casale; Carlotti, Ana P. C. P.

doi:10.1097/pcc.0000000000000685

Cited by 29 publications

(21 citation statements)

References 22 publications

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“…Many studies have revealed the association between PICU-AKI and hospital mortality. 1,5,8 What is unknown is the risk of long-term mortality in PICU survivors with AKI. The increased magnitude of the association between AKI and 30-day or 1-year mortality when hospital mortality was included highlights the importance of how this can bias the association of AKI with long-term mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Acute kidney injury (AKI) is common in the PICU and is associated with poor hospital outcomes. [1][2][3][4][5][6][7][8][9] Several studies in adults reveal that AKI is a risk factor for posthospital discharge mortality. [10][11][12][13][14][15] Some studies have revealed that hospitalized children with AKI appear to have higher long-term mortality rates than the general pediatric population; however, these studies lacked non-AKI comparison groups, precluding the ability to evaluate the association of AKI with mortality.…”

mentioning

confidence: 99%

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Long-term Mortality After Acute Kidney Injury in the Pediatric ICU

Hessey

Morissette

Lacroix

et al. 2018

Hospital Pediatrics

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Long-term Mortality After Acute Kidney Injury in the Pediatric ICU

Hessey

Morissette

Lacroix

et al. 2018

Hospital Pediatrics

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“…AKI is common in children admitted to the pediatric intensive care unit and is associated with higher hospital mortality and morbidity (1)(2)(3)(4)(5). In adults, AKI during a hospitalization is associated with higher risk for long-term kidney disease, cardiovascular morbidity, and hospital readmission (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Healthcare Utilization after Acute Kidney Injury in the Pediatric Intensive Care Unit

Hessey¹,

Morissette²,

Lacroix³

et al. 2018

CJASN

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“…There is wide variation in the reported incidence of AKI in critically ill children that were admitted to a pediatric intensive care unit (PICU), ranging from 4.5% to 82.0%. 1 , 2 This wide range is partly due to the lack of a standardized definition of AKI. It was not until 2004 that Acute Dialysis Quality Initiative experts decided to formulate a standard definition of AKI in adults by developing the RIFLE classification.…”

mentioning

confidence: 99%

Incidence and outcome of acute kidney injury by the pRIFLE criteria for children receiving extracorporeal membrane oxygenation after heart surgery

Elella

Habib

Mokrusova

et al. 2017

Annals of Saudi Medicine

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BACKGROUNDAcute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity.OBJECTIVESTo systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria.DESIGNRetrospective, medical records review.SETTINGSPediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh.PATIENTS AND METHODSWe reviewed the records of all pediatric patients that underwent cardiac surgery and required ECMO postoperatively between 1 January 2011 and 1 January 2016. AKI was classified according to the pRIFLE criteria 48 hours after ECMO initiation. Demographics and concomitant therapies for all patients were collected.MAIN OUTCOME MEASURE(S)Outcome was assessed by recovery from AKI at time of discharge, ICU stay and mortality.RESULTSFifty-nine patients needed ECMO after cardiac surgery during the study period. Their mean (SD) age and weight was 11.0 (16.5) month and 5.5 (3.6) kg, respectively. All patients had a central venoarterial ECMO inserted. Fifty-three patients (90%) developed AKI after ECMO initiation. The majority of patients (57%) were categorized as pRIFLE-Failure, having a higher mortality rate (28/34 patients, 82%) in comparison to the pRIFLE-Injury and pRIFLE-Risk groups. Twenty-nine patients (49%) required either peritoneal dialysis (PD), or renal replacement therapy (RRT) or both. For AKI vs non-AKI patients, there was a statistically significant difference between mean (SD) ECMO duration (9.0 [8.00] vs 6.0 [2.0] days; P=.02) and ICU stay (37.0 [41.0] vs 21.0 [5.0] days; P=.03), respectively. The overall mortality rate was 58%, with a significant difference (P=.03) between AKI and non-AKI groups. All the patients who survived had normal creatinine clearance at hospital discharge.CONCLUSIONThere is a high incidence of AKI in pediatric patients requiring ECMO after cardiac surgery, and it is associated with higher mortality, increased ECMO duration, and increased ventilator days.LIMITATIONSSingle-center retrospective analysis and the small sample size limited the precision of our estimates in sub-populations.

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Epidemiology and Outcome of Acute Kidney Injury According to Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease and Kidney Disease: Improving Global Outcomes Criteria in Critically Ill Children—A Prospective Study*

Abstract: Acute kidney injury defined by both pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease and Kidney Disease: Improving Global Outcomes criteria was associated with increased morbidity and mortality, and may lead to long-term renal dysfunction.

Cited by 29 publications

References 22 publications

Long-term Mortality After Acute Kidney Injury in the Pediatric ICU

Long-term Mortality After Acute Kidney Injury in the Pediatric ICU

Healthcare Utilization after Acute Kidney Injury in the Pediatric Intensive Care Unit

Incidence and outcome of acute kidney injury by the pRIFLE criteria for children receiving extracorporeal membrane oxygenation after heart surgery

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