Pediatric acute kidney injury in the ICU: an independent evaluation of pRIFLE criteria

Abstract

We observed a high incidence of significant AKI in a PICU population at risk, which was associated with high mortality. Pediatric RIFLE criteria may guide in the early identification of patients at risk for AKI and in the initiation of therapy.

Lesão renal aguda em crianças: incidência e fatores prognósticos em pacientes gravemente enfermos

“…Similarly, in the Plötz et al (26) study, 45% of the patients were diagnosed AKI in their first 24 hours. Akcan-Arikan et al (23) identified AKI in 42.3% of their sample.…”

“…Regarding the AKI level, the maximal RIFLE score found during the patients stay was 39.1% R, 39.1% I and 21.8 F, while Akcan-Arikan et al (23) found 48.8%, 26% and 25.2%, respectively, and Plötz et al (26) 52%, 37% and 11%, respectively.…”

“…In this cohort we observed that the mean ICU stay time increased as the AKI severity progressed. Differently, Plötz et al (26) showed no statistically significant differences between the control and AKI groups regarding the ICU time of stay. Akcan-Arikan et al (23) not only showed a trend in the exposed group to stay longer in the ICU, but also observed that AKI was an independent factor for increased hospital stay risk.…”

“…Ostermann and Chang (5) studied adult patients from the United Kingdom and Germany, and found a 35.8% incidence, while Host et al (22) found a 67.2% incidence and in a multicenter study, and Bagshaw et al (9) found an 36.1% incidence. Among children Akcan-Arikan et al (23) found an 82% incidence, while Plötz et al (26) found 58%.…”

“…Regarding mortality, several studies (5,7,9,16,19,22,26) have clearly shown that any degree of AKI is a poor prognosis indicator for critically ill patients. In this sample, we found that the in-hospital mortality of patients with the condition was ten times bigger than in the group with no AKI, according to the pRIFLE.…”