Acute kidney injury and its association with in-hospital mortality among children with acute infections

被引:33
作者
Imani, Peace D. [1 ,2 ]
Odiit, Amos [2 ]
Hingorani, Sangeeta R. [3 ,4 ]
Weiss, Noel S. [1 ]
Eddy, Allison A. [3 ,4 ]
机构
[1] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA
[2] Makerere Univ, Dept Paediat & Child Hlth, Sch Med, Coll Hlth Sci, Kampala, Uganda
[3] Univ Washington, Seattle Childrens Hosp & Res Inst, Seattle, WA 98105 USA
[4] Univ Washington, Dept Pediat, Seattle, WA 98105 USA
关键词
Acute kidney injury; Acute infections; Children; Mortality; Uganda; ACUTE-RENAL-FAILURE; CRITICALLY-ILL CHILDREN; CONGENITAL HEART-DISEASE; INTENSIVE-CARE-UNIT; LENGTH-OF-STAY; FALCIPARUM-MALARIA; SERUM CREATININE; CARDIAC-SURGERY; RISK-FACTORS; EPIDEMIOLOGY;
D O I
10.1007/s00467-013-2544-2
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
We investigated prevalence of acute kidney injury (AKI) at hospitalization and its association with in-hospital mortality among Ugandan children hospitalized with common acute infections, and predictors of mortality among AKI children. We enrolled 2,055 children hospitalized with primary diagnoses of acute gastroenteritis, malaria, or pneumonia. Serum creatinine, albumin, electrolytes, hemoglobin, and urine protein were obtained on admission. Participants were assessed for AKI based on serum creatinine levels. Demographic and clinical data were obtained using a primary care provider survey and medical chart review. Logistic regression was used to determine predictors of in-hospital mortality. A total of 278 (13.5 %) of children had AKI on admission; for 76.2 %, AKI was stage 2 (98/278) or stage 3 (114/278) defined as serum creatinine > 2- or 3-fold above normal upper limit for age, respectively. AKI prevalence was particularly high in gastroenteritis (28.6 %) and underweight children (20.7 %). Twenty-five percent of children with AKI died during hospitalization, compared to 9.9 % with no AKI (adjusted odds ratio (aOR) 3.5 (95 % CI, 2.2-5.5)). In-hospital mortality risk did not differ by AKI stage. Predictors of in-hospital mortality among AKI children included primary diagnosis of pneumonia, aOR 4.5 (95 % CI, 1.8-11.2); proteinuria, aOR = 2.1 (95 % CI, 1.0-4.9) and positive human immunodeficiency virus (HIV) status, aOR 5.0 (95 % CI, 2.0-12.9). Among children hospitalized with gastroenteritis, malaria, or pneumonia, AKI at admission was common and associated with high in-hospital mortality.
引用
收藏
页码:2199 / 2206
页数:8
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