scholarly journals Acute kidney injury and mortality in critically ill children

2014 ◽  
Vol 54 (5) ◽  
pp. 251
Author(s):  
Putri Amelia ◽  
Munar Lubis ◽  
Ema Mutiara ◽  
Yunnie Trisnawati
Keyword(s):  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Critically Ill Children ◽  
Cross Sectional ◽  
Logistic Organ Dysfunction ◽  
Stage Renal Disease

Background Mortality from acute kidney injury (AKI) can be ashigh as 60% in critically ill children. This high mortality rate isinfluenced by the severity of primary diseases, organ dysfunction,and the stage of acute kidney injury.Objective To assess for an as sedation between AKI and mortalityin critically ill children hospitalized in the pediatric intensive careunit (PICU).Methods A cross-sectional study was conducted from Aprilto July 2012. All patients aged 1 month to 18 years who werehospitalized in the PICU for more than 24 hours were included.Urine output and serum creatinine levels were evaluated daily.Patients were categorized according to the pediatric risk, injury,failure, loss, and end stage renal disease (pRIFLE) criteria. Chisquare, Fisher's exact, Mann-\X'hitney U, and Kruskal-Wallis testswere used to assess for an association between AKI, mortality,pediatric logistic organ dysfunction (PELOD) score, and lengthof PICU stay. AP value of < 0.05 was considered as statisticallysignificant.Results During the study period, 57 children were admitted,consisting of 25 (43.9%) females and 32 (56.1 %) males, witha median age of 43 months. The prevalance of AKI was 31.5%(18/57) and classified into stages: risk 13/18, injury 3/18, andfailure 2/18. The mortality rate for AKI was 16. 7%. There was noassociation between AKI and mortality (P=0.592). The PELODscores were found to be similar among patients (SD 11.3 2 vs. SD12.23; P=0.830), and there was no association between AKI andlength of PICU stay (P=0.819).Conclusion There is no association between AKI and mortalityin critically ill children admitted in PICU.

scholarly journals The Use of PELOD Score in Predicting Acute Kidney Injury in Critically Ill Children

2016 ◽  
Vol 36 (2) ◽  
pp. 165-169
Author(s):  
Risky Vitria Prasetyo ◽  
Putu Dian Saraswati ◽  
Muhammad Riza Kurniawan ◽  
Hari Kushartono ◽  
Ninik Asmaningsih Soemyarso ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Demographic Data ◽  
Kidney Injury ◽  
Prognostic Indicators ◽  
Critically Ill Children ◽  
Female Ratio ◽  
Logistic Organ Dysfunction ◽  
End Stage ◽  
Pelod Score

Introduction: Acute kidney injury (AKI) significantly increases morbidity and mortality in critically ill children. Prognostic indicators such as Pediatric Logistic Organ Dysfunction (PELOD) score is associated with factors related to renal dysfunction. The aim of this study was to study the AKI incidence and correlate the PELOD score with AKI in critically ill children admitted to PICU at Dr. Soetomo Hospital Surabaya Indonesia.Material and Methods: A prospective study was conducted to all children admitted to PICU during 15 January-14 April 2014. Demographic data (age, sex, PICU indications, PELOD scores, AKI staging by pRIFLE at admission) and outcome after 7 days at PICU were recorded. All data were analyzed descriptively (p<0.05).Results: A total of 56 (47.1%) out of 119 children were studied. The rest was excluded for being <3 months old, had end-stage kidney disease or complex cardiac problem, and cardiac catheterization. Mean age of subjects was 49.7 (SD 46.2) months, male-to-female ratio of 1.2:1. PICU indication was dominated by shock (35.7%), followed by CNS dysfunction in 13 (23.2%) and respiratory failure in 12 (21.4%) children. AKI was noted in 15 (26.8%) children, mostly (10.7%) in Injury stage with 5 (8.9%) in Risk and 4 (7.1%) in Failure stages. PELOD scores at admission ranged from 0 to 20 (mean 4.34, SD 5.87), higher scores in AKI group (7.8±6.64 vs 3.1±5.09, P=0.013). Twelve (21.4%) children died, 7 (58.3%) had AKI with 3 (25.0%) each in Risk and Failure while 1(8.3%) in Injury (p<0.05).Conclusion: PELOD score can be used as a predictor for AKI in critically ill children.J Nepal Paediatr Soc 2016;36(2):165-169.

scholarly journals Acute kidney injury in critically ill obstetric patients: a cross-sectional study in an intensive care unit in Northeast Brazil

2017 ◽  
Vol 39 (4) ◽  
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Suzanne Vieira Saintrain ◽  
Gabriel de Castro Castelo ◽  
Vanessa Ribeiro de Vasconcelos ◽  
Juliana Gomes Ramalho de Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Northeast Brazil ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Using pRIFLE criteria for acute kidney injury in critically ill children

2013 ◽  
Vol 53 (1) ◽  
pp. 32 ◽  
Author(s):  
Rina Amalia C. Saragih ◽  
Jose M. Mandei ◽  
Irene Yuniar ◽  
Rismala Dewi ◽  
Sudung O. Pardede ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Kidney Function ◽  
Urine Output ◽  
Clinical Course ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Logistic Organ Dysfunction ◽  
Significant Difference ◽  
Output Only

Backgi-ound Incidence of acute kidney injury (AKI) in critically illchildren and its mortality rate is high. The lack of a uniform definitionfor AKI leads to failure in determining kidney injury, delayedtreatment, and the inability to generalize research results.Objectives To evaluate the pediatric RIFLE (pRIFLE) criteria (riskfor renal dysfunction, injury to the kidney, failure of kidney function,loss of kidney function, and end-stage renal disease) for diagnosingand following the clinical course of AKI in critically ill children. Wealso aimed to compare AKI severity on days 1 and 3 of pediatricintensive care unit (PICU) stay in critically ill pediatric patients.Methods This prospective cohort study was performed in PICUpatients. Urine output (UOP), serum creatinine (SCr) , andglomerular filtration rate on days 1 and 3 of PICU stay wererecorded. Classification of AKI was determined according topRIFLE criteria. We also recorded subjects' immune status,pediatric logistic organ dysfunction (PELOD) score, admissiondiagnosis, the use of vasoactive medications, diuretics, andventilators, as well as PICU length of stay and mortality.Results Forty patients were enrolled in this study. AKI wasfound in 13 patients (33%). A comparison of AKI severity onday 1 and day 3 revealed no statistically significant differences forattainment of pRIFLE criteria by urine output only (pRIFLfu0 p;P=0.087) and by both UOP and SCr (pRIFLEcr+uo p; P= 0.577).However, attainment of pRIFLE criteria by SCr only (pRIFLEcrlwas significantly improved between days 1 and 3 (P =0.026). Therewas no statistically significant difference in mortality or length ofstay between subjects with AKI and those without AKI.Conclusion The pRIFLE criteria is feasible for use in diagnosingand following the clinical course of AKI in critically ill children.

scholarly journals Efficacy and safety of plasma hemodiafiltration (PHDF) in pediatric patients with multiple organ dysfunction syndrome with shock and DIC: a preliminary study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroyuki Nagafuchi ◽  
Hiroyuki Shimizu ◽  
Kaori Yamada ◽  
Kenta Shono ◽  
Tetsuya Ogawa
Keyword(s):  
Mortality Rate ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Venous Pressure ◽  
Multiple Organ ◽  
Critically Ill Children ◽  
Multiple Organ Dysfunction ◽  
Circulating Blood Volume ◽  
Logistic Organ Dysfunction

Abstract Background Multiple organ dysfunction syndrome is the leading cause of death in pediatric intensive care units and can be very critical when combined with shock and disseminated intravascular coagulation (DIC). Currently, there is no effective treatment. We developed a new hemodiafiltration (HDF) method called plasma HDF (PHDF) that uses fresh frozen plasma as replacement fluid and investigated the safety and efficacy of this treatment. Methods We enrolled critically ill children with (1) a Pediatric Logistic Organ Dysfunction 2 (PELOD-2) score ≥ 14, (2) a Japanese Ministry of Health and Welfare (JMHW) DIC score ≥ 7, (3) a vasoactive inotropic score (VIS) ≥ 10, and (4) a serum total protein concentration ≤ 5.0 g/dL. PHDF was performed for 5 h and then switched to continuous HDF. The primary endpoint was the 28-day mortality rate. Secondary endpoints included assessment of vital signs, blood test data, and fluid balance from PHDF start to day 7. Results Nine patients (four males and five females) between 3 days and 40 months of age, weighing 2.1–13 kg, met the inclusion criteria. Although the median PMR was 0.94 (0.71–0.96), the 28-day mortality rate was 22.2% (2/9). One hour after the start of PHDF, there was an increase in mean arterial pressure and central venous pressure and a decrease in heart rate; by day 7, there was a significant decrease in the PELOD-2 score, the JMHW DIC score, and the VIS. Hypoproteinemia also improved the day after PHDF. Water balance was able to remain negative after day 2. Conclusions PHDF was found to be effective in the treatment of DIC and circulatory failure by supplementing coagulation and antithrombotic factors as well as by raising colloid osmotic pressure to increase circulating blood volume. PHDF has been shown to be a safe and useful treatment for critically ill children and has the potential to improve 28-day survival.

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