Incidence and Outcome of Acute Kidney Injury In Hospitalized Children

Abstract Background: Acute kidney injury (AKI) is now increasingly common in hospitalized children with adverse short and long term outcomes. The objective of this study is to know the incidence, etiology and short term outcome of AKI in developing nation.Methods: This prospective observational study is done in pediatric wards and pediatric intensive care unit (PICU) of tertiary center of eastern Nepal, between age group 2 months to 14 years. AKI is defined according to pRIFLE criteria.Results: From May 2015 to March 2016 942 patient enrolled in Pediatric wards and PICU are evaluated. The incidence of AKI was 5.9% and 21.76% in PICU. AKI was commonest among cases having infectious etiology compromising 73.2% (n=41), 16.1%(n=9) due to primary renal disease , 5.35%(n=3) secondary to congenital heart disease, and 5.35% due to other causes. Inotropes was required in 55.4% (n=31) cases, nineteen(33.9%)required mechanical ventilator while 3 (5.36%) underwent hemodialysis. Out of 56 AKI patients 71.4% (n=40) improved and 28.6% (n=16) expired. Patient with AKI had significant longer duration of hospital stay as compared to Non AKI (7 day vs 3 days , P< 0.001). Mortality was high in AKI patient who required mechanical ventilation, inotropes (p<0.001) and AKI Injury and Failure stage(p=0.003) .Conclusion: The incidence of AKI is high in pediatric patients. Patients with AKI increases the duration of hospital stay and mortality is more in patients requiring mechanical ventilation and inotropes.