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. 2023 Jun;27(6):548-556.
doi: 10.1007/s10157-023-02339-9. Epub 2023 Mar 18.

Etiology and outcomes of acute kidney disease in children: a cohort study

Amar Murdeshwar  1 , Sriram Krishnamurthy  2 , Narayanan Parameswaran  1 , Medha Rajappa  3 , Bobbity Deepthi  1 , Sudarsan Krishnasamy  1 , Sachit Ganapathy  4 , Pediredla Karunakar  1
Affiliations

Etiology and outcomes of acute kidney disease in children: a cohort study

Amar Murdeshwar et al. Clin Exp Nephrol. 2023 Jun.

Abstract

Background: There is paucity of information regarding the etiology and outcomes of Acute Kidney Disease (AKD) in children.

Methods: The objectives of this cohort study were to evaluate the etiology and outcomes of AKD; and analyze predictors of kidney survival (defined as free of CKD 2, 3a, 3b, 4 or 5). Patients aged 1 month to 18 years who developed AKD over a 4-year-period (January 2018-December 2021) were enrolled. Survivors were followed-up at the pediatric nephrology clinic, and screened for residual kidney injury.

Results: Among 5710 children who developed AKI, 200 who developed AKD were enrolled. The median (IQR) eGFR was 17.03 (10.98, 28) mL/min/1.73 m2. Acute glomerulonephritis, acute tubular necrosis (ATN), hemolytic uremic syndrome (HUS), sepsis-associated AKD, and snake envenomation comprised of 69 (34.5%), 39 (19.5%), 24 (12%), 23 (11.5%) and 15 (7.5%) of the patients respectively. Overall, 88 (44%) children required kidney replacement therapy (KRT). There were 37 (18.5%) deaths within the AKD period. At a follow-up of 90 days, 32 (16%) progressed to chronic kidney disease stage-G2 or greater. At a median (IQR) follow-up of 24 (6, 36.5) months (n = 154), 27 (17.5%) had subnormal eGFR, and 20 (12.9%) had persistent proteinuria and/or hypertension. Requirement of KRT predicted kidney survival (free of CKD 2, 3a, 3b, 4 or 5) in AKD (HR 6.7, 95% CI 1.2, 46.4) (p 0.04).

Conclusions: Acute glomerulonephritis, ATN, HUS, sepsis-associated AKD and snake envenomation were common causes of AKD. Mortality in AKD was 18.5%, and 16% progressed to CKD-G2 or greater at 90-day follow-up.

Keywords: Acute kidney disease; Etiology; Kidney survival; Mortality; Pediatric; Risk factors.

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References

    1. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, Acute Disease Quality Initiative Workgroup 16, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017;13:241–57. - DOI - PubMed
    1. Gameiro J, Carreiro C, Fonseca JA, Pereira M, Jorge S, Gouveia L, et al. Acute kidney disease and long-term outcomes in critically ill acute kidney injury patients with sepsis: a cohort analysis. Clin Kidney J. 2020;14:1379–87. - DOI - PubMed - PMC
    1. Esposito P, Avella A, Ferrari F, Bruno G, Libetta C, Battaglia Y, et al. Renal outcomes of dialysis-dependent acute kidney injury in noncritically ill patients: a retrospective study. Blood Purif. 2022;51:390–6. - DOI - PubMed
    1. Chen YW, Wu MY, Mao CH, Yeh YT, Chen TT, Liao CT, et al. Severe acute kidney disease is associated with worse kidney outcome among acute kidney injury patients. Sci Rep. 2022;12:6492. - DOI - PubMed - PMC
    1. Yang M, Li Y, Li P, Fan Y, Zhang Y, Yuan R, et al. The effect of long-term duration renal replacement therapy on outcomes of critically ill patients with acute kidney injury: a retrospective cohort study. Evid Based Complement Alternat Med. 2021;2021:6623667. - PubMed - PMC

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