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

Abstract

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 postoperative 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.