| Abstract |
Introduction: Acute Kidney injury (AKI) is a common and a serious complication among patients admitted to the PICU. The incidence and outcome of AKI in PICUs is largely unknown hence this study was done to evaluate the incidence, severity and outcome of AKI in a tertiary level Pediatric intensive care unit. Materials and Methods: We screened all patients admitted to the PICU. We excluded patients who had chronic kidney disease and were on renal replacement therapy, and those whose duration of PICU stay was shorter than 48 hours. Standard demographic, clinical and investigational data was obtained prospectively from all the patients. AKI was defined based on the modified pRIFLE (pediatric Risk, Injury, Failure, Loss and End stage kidney disease) criteria. Results: Out of 114 patients; 50 patients developed AKI and 64 did not develop AKI and served as controls; 23 patients (20.1%) developed pRIFLEmax R AKI; 15 (13.1%) pRIFLEmax I and 12 (10.5%) pRIFLEmax F AKI. Patients with PRISM scores over 10 on day 1 were more likely to develop AKI (p < 0.01). Patients with AKI were at higher risk of death, significantly longer PICU stay, prolonged duration on mechanical ventilation and need for dialysis (p < 0.05). Conclusion: The incidence of AKI in PICU is very high (43.7% in our study) and it is associated with significant morbidity and mortality.
KEYWORDS: Acute kidney injury, pRIFLE, PICU. |
