Etiology and outcomes of acute kidney injury in Chinese children: a prospective multicentre investigation

Cao, Yan; Yi, Zhao; Zhang, Hui; Dang, Xiqiang; Wu, Xiaochuan; Huang, Aiwen

doi:10.1186/1471-2490-13-41

Cited by 37 publications

(37 citation statements)

References 25 publications

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“…Birleşik devletlerde 2009'da yapılan bir çalışmada şok, septisemi, mekanik ventilatör ve ekstrakorporeal destek ABH ile ilişkili olarak bulunmuştur (12). Çin'de yapılan çok merkezli prospektif bir çalışmada ise en sık etiyolojik faktör olarak ürolitiazis saptanmış bunu akut glomerulonefrit (AGN) ve ciddi dehidratasyon izlemiştir (13). Nijerya'da yapılmış bir çalışmada ABH'nın en sık nedeni olarak neftrotoksik ajanlar ve enfeksiyonlar görülmüştür Nefrotoksik ilaç kullanımı -9 (%17.6) 9 (%12.5)…”

Section: Discussionunclassified

Acute Kidney Injury: Classification and Prognosis

Şen¹,

Çakar²

2017

Turkish J Pediatr Dis

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ÖZETAmaç: Çalışma ile çocuk hastalarda Akut Böbrek Hasarının (ABH) etiyolojisi, klinik özellikleri, prognoz üzerinde etkili faktörleri ve sonuçları tanımlamak için Acute Kidney Injury Network tarafından öne sürülen sınıflandırma kriterlerinin kullanılması ve ABH sınıflandırılmasında pediatrik-modifiye RIFLE (pRIFLE) kriterlerinin rutine geçirilmesi amaçlanmıştır. Gereç ve Yöntemler:Mayıs 2008-Temmuz 2010 arasında ABH tanısı ile yatırılan ya da hastanede izlemi sırasında ABH gelişen %25'i yenidoğan 72 hasta (42 erkek, 30 kız) ileri doğru olarak incelendi. Bulgular:Hastaların ortanca yaşı 9.11 ay (minimum 0, maksimum 216.56 ay)'dı. ABH nedeni olarak dehidratasyon, %30.6 oranı ile en sık etiyolojik faktör olarak saptandı. Bunu sırasıyla hipoksi (%19.4), sepsis (%16.7), ilaç (%12.5) ve hemolitik üremik sendroma (%9.7) bağlı ABH izledi. Hastaların %15.3'ü risk, %25'i hasar, %59.7'si ise yetmezlik olarak sınıflandırıldı. Mortalite oranı %26.4'dü. Erkek cinsiyet, mekanik ventilasyon, nefrotoksik ilaç, ABH gelişimi sırasında hastanede yatıyor olmak, oligüri/anüri ve nefroloji konsültasyonunun gecikmesi mortalite ile ilişkili bulundu (p<0.05). Mortalite oranı risk grubunda %10.7, hasar grubunda %31.5 ve yetmezlik grubunda %57.8'di. ABSTrAcTObjective: The aim of this study was to use the classification criteria suggested by the Acute Kidney Injury Network in order to define the etiology, clinical features, prognostic factors and results of Acute Kidney Injury (AKI) in pediatric patients and to support the routine application of pediatric-modified RIFLE (pRIFLE) criteria for the classification of AKI. Material and Methods:The patient group comprised 72 patients (42 males, 30 females) of whom 25% were newborns and 75% were children aged >1 month, who were either hospitalized due to a diagnosis of AKI or in whom AKI had developed during hospitalization between May 2008 and July 2010. results:The median age at the time of AKI was 9.11 months (minimum 0, maximum 216.56 months). The etiology of AKI was dehydration in 30.6%, hypoxia in 19.4%, sepsis in 16.7%, drug-induced in 12.5% and hemolytic uremic syndrome in 9.7%. AKI patients were classified according to the staging system as follows: 15.3% of the patients were in the risk, 25% in the injury, and 59.7% in the failure category. The mortality rate was 26.4%. Male sex, mechanical ventilation, nephrotoxic drugs, hospitalization before the development of AKI, oliguria/anuria and delay in nephrology consultation were found to be associated with increased mortality (p<0.05). Mortality rate was 10.7% for the risk, 31.5% for the injury and 57.8 % for the failure categories. conclusion:The pRIFLE classification was an effective method in predicting the need for dialysis and hospital mortality.

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Section: Discussionunclassified

Acute Kidney Injury: Classification and Prognosis

Şen¹,

Çakar²

2017

Turkish J Pediatr Dis

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“…Cohorts have been limited to those with nephrotoxic medications, 3,6–8 cardiac surgery/bypass, 9,10 sepsis, 11,12 or admission to an intensive care unit. 3,413–15 Due to patient selection, these may not accurately convey overall AKI incidence.…”

mentioning

confidence: 99%

Acute Kidney Injury Incidence in Noncritically Ill Hospitalized Children, Adolescents, and Young Adults: A Retrospective Observational Study

McGregor

Jones

Wang

et al. 2016

American Journal of Kidney Diseases

109

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Background Acute kidney injury (AKI) has been characterized in young high-risk inpatients, in whom AKI is frequent and associated with increased mortality, morbidity, and length of stay. The incidence of AKI among patients not requiring intensive care is unknown. Study Design Retrospective cohort study Setting & Participants 13,914 noncritical admissions during 2011–2012 at our tertiary referral pediatric hospital were evaluated. Patients <28 days or >21 years of age, or with chronic kidney disease (CKD), were excluded. Admissions with ≥2 serum creatinine measurements were evaluated. Factors Demographic features, laboratory measurements, medication exposures, and length of stay. Outcome AKI defined by increased serum creatinine in accordance with KDIGO (Kidney Disease: Improving Global Outcomes) criteria. Based on time of admission, time interval requirements were met in 97% of cases, but KDIGO time window criteria were not strictly enforced to allow implementation using clinically-obtained data. Results Two or more creatinine measurements (one baseline before or during admission, and a second during admission) in 2,374 of 13,914 (17%) patients allowed for AKI evaluation. A serum creatinine difference of ≥0.3 mg/dL or ≥1.5 times baseline was seen in 722 of 2,374 (30%) patients. A minimum of 5% of all noncritical inpatients without CKD in pediatric wards have an episode of AKI during routine hospital admission. Limitations Urine output, glomerular filtration rate, and time interval criteria for AKI were not applied secondary to study design and available data. The evaluated cohort was restricted to patients with ≥2 clinically obtained serum creatinine measurements, and baseline creatinine may have been measured after the AKI episode. Conclusions AKI occurs in at least 5% of all non-critically ill hospitalized children, adolescents, and young adults without known CKD. Physicians should increase their awareness of AKI and improve surveillance strategies with serum creatinine measurements in this population so that exacerbating factors such as nephrotoxic medication exposures may be modified as indicated.

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“…There were many cases of renal failure in children in China where melamine was added to infant formula (Cao et al 2013). Melamine and cyanuric acid were also detected in feed for cats and dogs in the U.S. as a component accompanying wheat gluten, rice protein, and corn gluten imported from China, again probably with the objective to increase the content of nitrogen-containing substances, however, as a result a nephrotoxic renal failure developed in lots of dogs and smaller number of cats (Brown et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Effect of melamine and cyanurid acid contaminated diets on blood indicators in broiler chickens

Straková¹,

Karásková²,

Zapletal³

et al. 2014

CZECH J ANIM SCI

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ABSTRACT:The effect of melamine and cyanuric acid contaminated diets on basic haematological and biochemical blood indicators in male broiler chickens (Ross 308) was studied. The chickens were divided into 6 experimental groups (30 birds per group) and fed diets with an addition of 50 or 100 mg of melamine or 50 or 100 mg of cyanuric acid per kg of feed, with the contaminants added separately (either melamine or cyanuric acid) or in combination (melamine + cyanuric acid). The control group (C) was fed a diet without melamine or cyanuric acid. At the end of the experiment (day 40), 8 birds per treatment group were randomly selected for haematological and biochemical examination of blood. Red blood cell count, haemoglobin concentration, haematocrit value, mean corpuscular haemoglobin concentration, mean corpuscular haemoglobin, mean cell volume, and total leukocyte count did not differ significantly among the respective groups of broiler chickens (P > 0.05). The concentrations of melamine and cyanuric acid used in the contaminated diet for broiler chickens led to highly significant changes in the content of total protein (TP), glucose (Glu), Ca, P, Na, and K (P < 0.01) and to significant changes in the content of Mg (P < 0.05) in their blood plasma. In comparison to the C group, the decrease in the content of TP, Glu, Ca, P, Na, K, and Mg in blood plasma was most pronounced in broilers fed the diets contaminated with cyanuric acid only or diets with the simultaneous contamination with melamine and cyanuric acid. On the basis of our results, it can be concluded that the contamination of feed with melamine and cyanuric acid, separately or in combination, results in impaired renal function and probably also in partial liver damage.Keywords: poultry; feed; level of contaminants; haematological indicators; biochemical indicators; toxicity List of abbreviations: AST = aspartate aminotransferase, Chol = cholesterol, Er = total red blood cell count, Glu = glucose, Hb = haemoglobin concentration, Ht = haematocrit value, Leu = total leukocyte count, MCH = mean corpuscular haemoglobin, MCHC = mean corpuscular haemoglobin concentration, MCV = mean cell volume, TP = total protein, UA = uric acid

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Etiology and outcomes of acute kidney injury in Chinese children: a prospective multicentre investigation

Cited by 37 publications

References 25 publications

Acute Kidney Injury: Classification and Prognosis

Acute Kidney Injury: Classification and Prognosis

Acute Kidney Injury Incidence in Noncritically Ill Hospitalized Children, Adolescents, and Young Adults: A Retrospective Observational Study

Effect of melamine and cyanurid acid contaminated diets on blood indicators in broiler chickens

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