Clinical profile of children with acute kidney injury in a tertiary care centre from southern India

Introduction: Acute kidney injury/impairment (AKI) includes the entire spectrum of the syndrome from minor changes in markers of renal function to the requirement of renal replacement therapy.

Objective: To study the incidence, clinical profile and outcome of AKI in the paediatric intensive care unit (PICU) of a tertiary care centre from South India. 

Method: A prospective observational study was conducted in a paediatric tertiary health care centre from South India. All children between 1 month and 18 years of age, admitted to the PICU from October 2015 to April 2016 were included in the study. Children with known pre-existing renal disease, children who underwent renal replacement therapy before admission and children admitted for post-operative care and who were discharged within 48 hours or against medical advice, were excluded from the study.

Results: A total of 310 children was admitted to the PICU during the study period and 262 were considered for the study after excluding 48 cases. Male-female ratio in the study group was 1.12:1. At admission, AKI was present in 8% (21 out of 262), at 48 hours in 7.9% (20 out of 252, 10 children expired before 48hrs). Overall, pRIFLE criteria were observed in 31 (11.8%) out of 262 children during the hospital stay. The overall mortality rate of the study group was 9.2%. The length of PICU and hospital stay was significantly longer in children with AKI when compared to children without AKI (p-values 0.003 and <0.001 respectively). Most common aetiology implicated in the present study was sepsis (64.5%).

Conclusions: The incidence of AKI in the PICU of the tertiary centre from South India was 8%, the mortality rate was 9.2% and the most common aetiology implicated (64.5%) was sepsis.

Sri Lanka Journal of Child Health, 2018; 47(4): 338-341