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246848

Acute Kidney Injury In Children Admitted In Pediatric Intensive Care Unit

Article

Last updated: 22 Jan 2023

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Abstract

Background: Acute kidney injury (AKI) poses a significant burden for the society, in terms of health resource use during the acute phase, and the potential long-term sequelae including development of chronic kidney disease and kidney failure. 
Aim of the work: to investigate the risk of development of AKI in critically ill children.
Material and methods: A cohort study conducted on 60 critically ill children admitted at pediatric intensive care unit (PICU). They were divided into two groups according to hemodynamic stability. Cardiovascular parameters together with criteria for AKI were observed during the first 5 days of PICU admission. AKI was diagnosed based on Acute Kidney Injury Network criteria. 
Results: From all critically ill included patients (60 patients); thirty four patients developed AKI (56.6%). Frequency of AKI was significantly more in hemodynamically unstable than stable patients 22 (73%) versus 12 (40%) (p=0.018). AKI was strongly associated with decreased baseline systolic and diastolic blood pressure percentiles (p=0.04) and (p=0.049), increased doses and duration of inotropic support determined by vasoactive inotropic score (p=0.002 and 0.013 respectively), higher base deficit in baseline blood gases (p=0.002), multiple organ dysfunctions (p < 0.001) and exposure to nephrotoxic agents (p=0.036).
Conclusion: AKI is a common morbidity among hemodynamically unstable critically ill children. AKI is strongly associated with initial hypotension on admission, increased doses and longer duration of inotropic support, increased base deficit in initial blood gases evaluation, multiple organ dysfunctions and exposure to nephrotoxic agents. 

DOI

10.21608/cupsj.2022.128890.1047

Keywords

Acute kidney injury, Hemodynamic instability, pediatric intensive care unit

Authors

First Name

Aly

Last Name

Elkazaz

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

alyelkazaz1@gmail.com

City

-

Orcid

-

First Name

Hafez

Last Name

Bazaraa

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

hmbazaraa@kasralainy.edu.eg

City

Cairo

Orcid

0000-0002-4893-9274

First Name

Doaa

Last Name

Salah

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

doaasalah@kasralainy.edu.eg

City

Cairo

Orcid

0000-0003-2601-9773

First Name

Ahmed

Last Name

El Nahas

MiddleName

-

Affiliation

Department of Pediatrics, El Galaa Hospital, Egypt

Email

drahmedelnahas@yahoo.com

City

-

Orcid

-

First Name

Shaimaa

Last Name

Sayed

MiddleName

-

Affiliation

Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt

Email

shaimaasayed@kasralainy.edu.eg

City

Cairo

Orcid

0000-0002-9009-165X

Volume

2

Article Issue

2

Related Issue

35212

Issue Date

2022-07-01

Receive Date

2022-03-22

Publish Date

2022-07-01

Page Start

178

Page End

192

Print ISSN

2805-279X

Online ISSN

2682-3985

Article File

CUPSJ_Volume 2_Issue 2_Pages 178-192.pdf

PDF . 1.8MB

Link

https://cupsj.journals.ekb.eg/article_246848.html

Detail API

https://cupsj.journals.ekb.eg/service?article_code=246848

Order

9

Type

Original Research

Type Code

1,229

Publication Type

Journal

Publication Title

Pediatric Sciences Journal

Publication Link

https://cupsj.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023