Acute Kidney Injury in a Single Pediatric Intensive Care Unit in Poland: A Retrospective Study

被引:10
作者
Miklaszewska, Monika [1 ]
Korohoda, Przemyslaw [2 ]
Sobczak, Alina [3 ]
Horbaczewska, Anna [3 ]
Filipiak, Agata [3 ]
Zachwieja, Katarzyna [1 ]
Kobylarz, Krzysztof [4 ]
Tkaczyk, Marcin [5 ]
Drozdz, Dorota [1 ]
Pietrzyk, Jacek A. [1 ]
机构
[1] Jagiellonian Univ, Coll Med, Dept Pediat Nephrol, PL-30663 Krakow, Poland
[2] AGH Univ Sci & Technol, Fac Comp Sci Elect & Telecommun, Dept Elect, Krakow, Poland
[3] Jagiellonian Univ, Coll Med, Students Sci Soc, Dialysis Dept,Students Sci Grp 2, PL-30663 Krakow, Poland
[4] Jagiellonian Univ, Coll Med, Polish Amer Inst Pediat, Dept Anesthesiol & Intens Care, PL-30663 Krakow, Poland
[5] Polish Mothers Mem Hosp, Res Inst, Div Nephrol, Lodz, Poland
关键词
Acute kidney injury; Children; Pediatric intensive care; Urine output; CRITICALLY-ILL CHILDREN; ACUTE-RENAL-FAILURE; MODIFIED RIFLE CRITERIA; EPIDEMIOLOGY; MORTALITY; PRIFLE; CLASSIFICATION; DISEASE; SCORE; RISK;
D O I
10.1159/000355774
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Background/Aims: The recent improvements of management of patients in pediatric intensive care units (PICU) are associated with improved outcome. However, this decrease in mortality is associated with an increased number of children with acute kidney injury (AKI), especially in patients with multiorgan failure. Methods: The report presents a retrospective analysis of 25 cases of AKI (assessed based on the pRIFLE criteria) in PICU within 7 years. Results: AKI was diagnosed in 1.24% of all hospitalized children. AKI percentage duration (as compared to the total hospitalization time) in the children who died vs. the survivors was 79.55% vs. 46.19%, respectively (p<0.05). The mortality rate of AKI patients was 40% which was 4.4-times higher as compared to the total mortality rate in PICU. The final cumulative survival ratio (FCSR) of patients meeting the oliguria criterion (which was met in 48% of AKI patients) was 37% vs. 49% in non-oliguric children. Averaged urine output values in the first week of hospitalization in the deceased vs. survivors were 1.49 vs. 2.57 ml/kg/h, respectively (p<0.05). Conclusions: Oliguria should not be considered as a sensitive parameter for AKI diagnosing in children below one year of age. A decreased mean urine output in the first week of PICU hospitalization (less than 1.4 ml/kg/h) should be considered as a poor prognostic factor. In many cases AKI was diagnosed too infrequently and too late. Copyright (C) 2014 S. Karger AG, Basel
引用
收藏
页码:28 / 39
页数:12
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