Prevalence and Mortality of Post-traumatic Acute Kidney Injury in Children; a Systematic Review and Meta-analysis
Archives of Academic Emergency Medicine,
Vol. 10 No. 1 (2022),
1 January 2022
,
Page e89
https://doi.org/10.22037/aaem.v10i1.1660
Abstract
Introduction: Numerous studies on acute kidney injury (AKI) following trauma have been performed, and acceptable findings have been reported in the adult population. The present meta-analysis summarizes the studies performed on the pediatric population to evaluate the prevalence of AKI following trauma in this population.
Method: The Medline, Embase, Scopus and Web of Sciences databases were searched for articles published until the July, 31, 2021. Two independent reviewers screened observational studies performed on children with physical trauma and AKI related to it. The interested outcomes were the prevalence and mortality of trauma-related AKI in traumatized children.
Results: Data of 9 articles were included in the present meta-analysis. The prevalence of trauma-related AKI varied between 0% and 30.30% among included studies. Pooled analysis showed that the prevalence of trauma-related AKI was 9.86% (95% CI: 8.02 to 11.84%). The prevalence of AKI after exertional rhabdomyolysis, direct physical trauma, and earthquake related injuries was 0%, 12.64% and 24.60%, respectively. There was a significant relationship between the prevalence of AKI and trauma etiology (p = 0.038). Moreover, the occurrence of AKI in children with trauma was associated with an increased risk of mortality (OR = 5.55; 95% CI: 2.14 to 13.93).
Conclusion: The findings of the present study showed that 9.86% of children develop AKI following trauma, which may increase their risk of death by about 5.5 times. Nevertheless, since none of the studies had adjusted their analyzes for potential confounders, caution should be exercised in interpreting the relationship between trauma-related AKI and mortality.
- Multiple trauma
- pediatrics
- acute kidney injury
- earthquakes
- exercise
- rhabdomyolysis
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References
Schneider J, Khemani R, Grushkin C, Bart R. Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit. Crit Care Med. 2010;38(3):933-9.
Goldstein SL, Devarajan P. Pediatrics: Acute kidney injury leads to pediatric patient mortality. Nat Rev Nephrol. 2010;6(7):393-4.
Harrois A, Libert N, Duranteau J. Acute kidney injury in trauma patients. Curr Opin Crit Care. 2017;23(6):447-56.
Haines RW, Fowler AJ, Kirwan CJ, Prowle JR. The incidence and associations of acute kidney injury in trauma patients admitted to critical care: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2019;86(1):141-7.
Burmeister DM, Gomez BI, Dubick MA. Molecular mechanisms of trauma-induced acute kidney injury: Inflammatory and metabolic insights from animal models. Biochim Biophys Acta Mol Basis Dis. 2017;1863(10 Pt B):2661-71.
Civiletti F, Assenzio B, Mazzeo AT, Medica D, Giaretta F, Deambrosis I, et al. Acute Tubular Injury is Associated With Severe Traumatic Brain Injury: in Vitro Study on Human Tubular Epithelial Cells. Sci Rep. 2019;9(1):6090.
Perkins ZB, Captur G, Bird R, Gleeson L, Singer B, O'Brien B. Trauma induced acute kidney injury. PLoS One. 2019;14(1):e0211001.
Ramirez ME, McQuillan RF. Acute Kidney Injury Secondary to Trauma-Induced Hemolysis: The Need for Increased Awareness and a Preventative Strategy. Am J Kidney Dis. 2017;69(2):320.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-12.
Leclercq E, Leeflang MMG, van Dalen EC, Kremer LCM. Validation of Search Filters for Identifying Pediatric Studies in PubMed. J Pediatr. 2013;162(3):629-34.e2.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-9.
National Institutes of Health. National Heart Lung, and Blood Institute. Quality assessment tool for observational cohort and cross-sectional studies 2014 [Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.
Bjornstad EC, Muronya W, Smith ZH, Gibson K, Mottl AK, Charles A, et al. Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study. BMC Nephrol. 2020;21(1):1-12.
Chen C-Y, Lin Y-R, Zhao L-L, Yang W-C, Chang Y-J, Wu K-H, et al. Clinical spectrum of rhabdomyolysis presented to pediatric emergency department. BMC Pediatr. 2013;13(1):134.
Guardenier A, Peterson B, Hilfiker M, Shellington D. 1170: Acute renal failure in pediatric patients after moderate to severe traumatic brain injury. Crit Care Med. 2015;43(12):294.
Hatamizadeh P, Najafi I, Vanholder R, Rashid-Farokhi F, Sanadgol H, Seyrafian S, et al. Epidemiologic aspects of the Bam earthquake in Iran: the nephrologic perspective. Am J Kidney Dis. 2006;47(3):428-38.
Iskit SH, Alpay H, Tuğtepe H, Özdemir C, Ayyıldız SH, Özel K, et al. Analysis of 33 pediatric trauma victims in the 1999 Marmara, Turkey earthquake. J Pediatr Surg. 2001;36(2):368-72.
Lin H, Chie W, Lien H. Epidemiological analysis of factors influencing an episode of exertional rhabdomyolysis in high school students. Am J Sports Med. 2006;34(3):481-6.
Oh JY, Laidler M, Fiala SC, Hedberg K. Acute exertional rhabdomyolysis and triceps compartment syndrome during a high school football camp. Sports Health. 2012;4(1):57-62.
Prodhan P, McCage LS, Stroud MH, Gossett J, Garcia X, Bhutta AT, et al. Acute kidney injury is associated with increased in-hospital mortality in mechanically ventilated children with trauma. J Trauma Acute Care Surg. 2012;73(4):832-7.
Talving P, Karamanos E, Skiada D, Lam L, Teixeira PG, Inaba K, et al. Relationship of creatine kinase elevation and acute kidney injury in pediatric trauma patients. J Trauma Acute Care Surg. 2013;74(3):912-6.
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