ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2012;1(2):101-108.
doi:10.5812/nephropathol.7534
PMID: 24475397
PMCID: PMC3886134

Scopus id: 84866750694

Original Article

Acute kidney injury: A pediatric experience over 10 years at a tertiary care center

Alaleh Gheissari 1 * , Pardis Mehrasa 1, Alireza Merrikhi 1, Yahya Madihi 1

1 Isfahan Kidney Diseases Research Center and Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran.
*Corresponding author: Dr. Alaleh Gheissari, Isfahan Kidney Diseases Research Center, Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran. Telephone: 00983112235043, Fax: 00983112235043 Email: gheisari@med.mui.ac.ir

Abstract

Background: The etiology of acute kidney injury (AKI) varies in different countries. In addition, the etiology of AKI in hospitalized children is multifactorial. The importance of diagnosing AKI is not only because of short-term high morbidity and mortality rate, but also for its effect on developing chronic kidney disease.

Objectives: we studied retrospectively AKIs of children who were hospitalized over 10 years in a University hospital.

Materials and Methods: A retrospective analysis of the medical recorded data of 180 children less than 18 years treated for AKI in Alzahra Hospital, Isfahan, Iran, were performed during the period of March 2001 to February 2011. For each patient, demographic and anthropometric data, laboratory data, electrocardiographic findings, ultrasound results, etiology of AKI and short-term outcomes were recorded.

Results: The male to female ratio was 1.57 to 1. Mean age was 5.28 ± 6.3 (SD) years and the median was 1.8 years. The more frequent age group was children less than 2 years. The mortality rate was 22.2% (40 patients). The mortality was not correlated with age (p= 0.74). Renal replacement therapy was recommended for 62 patients (34.4%). Mean of the first and last glomerular filtration rate (GFR) were 18.33± 1.12 ml/min/1.73 m² and 52.53 ± 2.98 ml/min/1.73 m², respectively. The most common urinary sediment finding in approximately 70% of the patients was either renal epithelial cell or renal cell cast. Increased kidney echogenicity was the most common ultrasound finding (48%). Using ANOVA regression analysis, the etiology of disease was the only predictor of mortality (p=0.0001).

Conclusions: We concluded that the mortality is still high in AKI. Furthermore, the poor outcome (defined as low GFR) are higher among patients with low levels of first GFR and higher RIFLE score.

Implication for health policy/practice/research/medical education:

The etiology of acute kidney injury (AKI) varies in different countries. In a retrospective analysis data of 180 children less than 18 years treated for AKI was studied. We concluded that the mortality is still high in AKI. The poor outcome (defined as low GFR) are higher among patients with low levels of first GFR and higher RIFLE score.

Please cite this paper as: Gheissari A, Mehrasa P, Merrikhi A, Madihi Y. Acute kidney injury: A pediatric experience over 10 years at a tertiary care center. J Nephropathology. 2012; 1(2): 101-108. DOI: 10.5812/nephropathol.7534

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Revised: 10 May 2012

First published online: 01 Jul 2012
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