Patient level factors increase risk of acute kidney disease in hospitalized children with acute kidney injury

Patel, Mital; Hornik, Christoph P.; Diamantidis, Clarissa J.; Selewski, David T.; Gbadegesin, Rasheed

doi:10.1007/s00467-023-05997-9

Cited by 8 publications

(21 citation statements)

References 29 publications

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“…The incidence of AKD in our cohort was 17%. This was consistent with previous reported data in children from 1 month to 18 years old where the incidence of AKD ranged between 6 and 56% [ 13 , 14 , 15 , 16 , 17 ]. However, the data are heterogeneous and comprised patients from a wider age spectrum.…”

Section: Discussionsupporting

confidence: 94%

“…To the best of our knowledge, this is the first study from Europe that evaluated AKD following an AKI episode in children using the KDIGO criteria and third in the world, after Deng’s study from China [ 17 ] and Patel’s study from USA [ 13 ]. In this study, we showed that AKD is quite common among children aged from 2 to 18 years old, following an AKI episode, and is associated with worse clinical and biological markers.…”

Section: Discussionmentioning

confidence: 99%

“…As we mentioned above, there are only two studies that evaluated mixed paediatric patient cohorts, including children between 1 month and 18 years old. One study, by Deng, reported an AKD incidence of 42.3% in 990 AKI children from China [ 17 ] and the other study, by Patel, reported a 56.3% incidence [ 13 ]. Our reported AKD incidence is lower compared to Patel and Deng.…”

Section: Discussionmentioning

confidence: 99%

“…The latest meta-analysis in adults by Su showed that AKD is an independent risk factor for mortality, CKD development and kidney failure [ 12 ]. However, only a few studies evaluated the evolution of AKI towards AKD in children [ 13 , 14 , 15 , 16 , 17 ]. Three of the aforementioned studies evaluated AKD incidence and outcomes in specific groups of children, either in transplantation (allogenic hematopoietic stem cell) [ 16 ] or non-kidney solid organ transplantation [ 14 ] or following cardiopulmonary by-pass [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Three of the aforementioned studies evaluated AKD incidence and outcomes in specific groups of children, either in transplantation (allogenic hematopoietic stem cell) [ 16 ] or non-kidney solid organ transplantation [ 14 ] or following cardiopulmonary by-pass [ 15 ]. The latter two studies, by Deng [ 17 ] and Patel [ 13 ], evaluated AKD incidence and outcomes in a mixed group of paediatric patients aged between 1 month and 18 years old.…”

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Disease following Acute Kidney Injury in Children—A Retrospective Observational Cohort Study on Risk Factors and Outcomes

Chisavu,

Ivan

et al. 2024

JCM

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Background: Acute kidney disease (AKD) is a known risk factor for increased mortality and evolution towards chronic kidney disease (CKD) in adults. The data regarding AKD in children are scarce. The purpose of our study was to explore the risk factors for developing AKD based on exposures and susceptibilities in children with AKI doubled by the biological parameters from the first day of identified AKI. In addition, we followed the trajectory of AKD following an acute kidney injury (AKI) episode in children during hospital admission and after discharge with special considerations towards mortality and progression to new-onset CKD. Methods: We retrospectively evaluated 736 children, ages between 2 and 18 years old, with identified AKI during hospital admission in a tertiary care hospital from west Romania over a 9-year period. Results: AKD incidence following an AKI episode was 17%. Patients who developed AKD were older, with higher baseline serum creatinine, urea, C reactive protein and lower proteins, haemoglobin and sodium levels. In the adjusted model, no biological parameters influenced AKD development. Regarding certain exposures and personal susceptibilities in children with AKI, only anaemia independently increased the risk of AKD development by 2.47 times. However, out of the AKI causes, only the intrinsic causes of AKI independently increased the risk of progressing to AKD (glomerulonephritis by 4.94 and acute tubule-interstitial nephritis by 2.76 times). AKD increased the overall mortality by 2.6 times. The factors that independently increased the risk of CKD were AKD, acute tubular necrosis and higher baseline serum creatinine values. Conclusions: Only anaemia, glomerulonephritis and acute tubule-interstitial nephritis increased the risk of AKD development in children with AKI. AKD was an independent risk factor for mortality and new-onset CKD in children.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Kidney Disease following Acute Kidney Injury in Children—A Retrospective Observational Cohort Study on Risk Factors and Outcomes

Chisavu,

Ivan

et al. 2024

JCM

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A reappraisal of risk factors for hypertension after pediatric acute kidney injury

Patel,

Hornik,

Diamantidis

et al. 2023

Pediatr Nephrol

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Outcomes of acute kidney injury continuum in children

Chisavu,

Gafencu,

Stroescu

et al. 2024

J Nephrol

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Background Acute kidney injury (AKI) is associated with high morbidity and mortality. The continuum of kidney damage after an AKI episode is poorly explored in the paediatric population. Methods We performed a retrospective cohort study on 2346 children with AKI from a tertiary care hospital in Romania over a 9-year period. The main objective was to evaluate the impact of AKI duration on mortality and the risk of new-onset chronic kidney disease (CKD). Results Out of 2346 AKI patients, transient AKI was present in 655 patients (27.9%), persistent AKI in 1009 children (43%) and acute kidney disease in 682 patients (29.1%). In contrast to transient AKI, children who developed acute kidney disease were younger, with a higher degree of anaemia, lower number of platelets, higher procalcitonin, higher LDH, higher GGT, higher urea and higher serum creatinine levels. The pre-renal cause of AKI was the leading cause regardless of AKI duration. As kidney injury progressed over time, there was an increasing incidence of the intrinsic causes of AKI (11.1% in transient AKI, 13.2% in persistent AKI and 22.6% in acute kidney disease). Acute kidney disease patients had the highest mortality rate (16.42%), followed by transient AKI (14.66%) and persistent AKI (9.81%). Overall mortality increased in the presence of renal microvascular alterations, acute tubular necrosis, lower haemoglobin, serum proteins and platelets, and higher procalcitonin levels. Conclusions The continuum of AKI expressed as acute kidney disease resulted in an increased risk of new-onset CKD. CKD was influenced by the intrinsic cause of AKI and not by AKI severity. Graphical abstract

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Patient level factors increase risk of acute kidney disease in hospitalized children with acute kidney injury

Cited by 8 publications

References 29 publications

Acute Kidney Disease following Acute Kidney Injury in Children—A Retrospective Observational Cohort Study on Risk Factors and Outcomes

Acute Kidney Disease following Acute Kidney Injury in Children—A Retrospective Observational Cohort Study on Risk Factors and Outcomes

A reappraisal of risk factors for hypertension after pediatric acute kidney injury

Outcomes of acute kidney injury continuum in children

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