Etiology and Outcomes of Acute Kidney Injury: A Comprehensive Study in Four Tertiary Centers of Dhaka
Journal of Pediatric Nephrology,
Vol. 5 No. 1 (2017),
Introduction: This study was conducted to determine the etiology and outcomes of AKI in 4 tertiary centers of Dhaka, Bangladesh irrespective of RRT requirement and the hospital setting in which they were treated.
Materials and Methods: This retrospective study was carried out in 4 tertiary care centers (Bangabandhu Sheikh Mujib Medical University, National Institute of Kidney Disease and Urology, Dhaka Shishu Hospital, and Dhaka Medical College Hospital) and 3 NICUs (Bangabandhu Sheikh Mujib Medical University, Dhaka Shishu Hospital and Dhaka Medical College Hospital of Dhaka) from January 2013 to December 2014. For the purpose of this study, AKI was defined according to the pediatric RIFLE (risk, injury, failure, loss, and end stage) criteria. All children admitted to the Pediatric Nephrology Inpatient Department and NICU of these hospitals were enrolled in the study. Data were collected from the registry of the hospitals. Ethics approval was obtained from the Institutional Review Board.
Results: A total of 2285 patients in the Nephrology Ward and 3764 patients in the NICU were included in the study. About 8.1% (185) of the patients had AKI, and the death rate was 18.5%. Out of 3764 children in the NICU, 530 had AKI and 17.2% of the patients died.
Conclusions: The renal cause of AKI was the most predominant causes in our setting in hospitalized patients and perinatal asphyxia was a predominant cause of AKI in neonates. The overall mortality rate was 13-26%, which is comparable to other South Asian countries.
Keywords: Acute kidney injury; Etiology; Outcome; Child.
How to Cite
Mehta RL, Pascual MT, Soroko S, Savage BR, HimmelfarbJ, Ikizler TA, Paganini EP, Chertow GM; Program to Improve Care in Acute Renal Disease: Spectrum of acute renal failure in the intensive care unit: The PICARD experience. Kidney Int66:2004;1613–1621.
Carbonell N, Blasco M, Sanjuan R, Garcia-Ramon R, BlanquerJ, Carrasco AM: Acute renal failure in critically ill patients: A prospective epidemiological study. Nefrologia 2004;24:47–53.
Bahloul M, Ben Hamida C, Damak H, Kallel H, Ksibi H, Rekik N, Chelly H, Bouaziz M: Incidence and prognosis of acute renal failure in the intensive care unit: Retrospective study of 216 cases. Tunis Med 2003;81:250–257.
Cole L, Bellomo R, Silvester W, Reeves JH: A prospective, multicenter study of the epidemiology, management, and outcome of severe acute renal failure in a “closed” ICU system. Am J RespirCrit Care Med 2000;162: 191–196.
Stevens PE, Tamimi NA, Al-Hasani MK, Mikhail AI, Kearney E, Lapworth R, Prosser DI, Carmichael P: Nonspecialistmanagement of acute renal failure. QJM 2001;94: 533–540.
Khan IH, Catto GR, Edward N, Macleod AM: Acute renal failure: Factors influencing nephrology referral and outcome. QJM 1997;90: 781–785.
Firmat J, Zucchini A, Martin R, Aguirre C: A study of 500 cases of acute renal failure (1978 –1991). Ren Fail 1994;16: 91–99.
Metcalfe W, Simpson M, Khan IH, Prescott GJ, Simpson K, Smith WC, MacLeod AM, Scottish Renal Registry: Acute renal failure requiring renal replacement therapy: Incidence and outcome. QJM 2002;95: 579–583.
Feest TG, Round A, Hamad S: Incidence of severe acute renal failure in adults: Results of a community based study. BMJ 1993;306: 481–483.
Liano F, Pascual J: Epidemiology of acute renal failure: A prospective, multicenter, community-based study. Madrid Acute Renal Failure study group. Kidney Int 1996;50: 811–818.
Waikar SS, Curhan GC, Wald R, McCarthy EP, ChertowGM: Declining mortality in patients with acute renal failure, 1988 to 2002. J Am SocNephrol 2006;17: 1143–1150.
Lip GYH, Churchill D, Beevers M, Auckett A, Beevers DG Angiotensin converting enzyme inhibitors in early pregnancy. Lancet 1997;350:1446–1447.
Martinovic J, Benachi A, Laurent N, Daikha-Dahmane F, BuglerMC Fetal toxic effects and angiotensin-II-receptor antagonists. Lancet 2001;358:241–242.
Cooper WO, Hernandez-Diaz S, Arbogast PG, Dudley JA, DyerS, Gideon PS, Hall K, Ray WA Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med 2006;354:2443–2451.
Benini D, Fanos V, Cuzzolin L, Tato L In utero exposure to nonsteroidal anti-inflammatory drugs: neonatal acute renal failure. PediatrNephrol 2004;19:232–234.
Acute Kidney Injury Network, Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, et al. Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31.
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;38:933-9.
Ozcakar ZB, Yalcinkaya F, Altas B, Ergün H, Kendirli T, Ates C, et al. Application of the new classification criteria of the Acute Kidney Injury Network: a pilot study in a pediatric population. Pediatr Nephrol. 2009;24:1379-84.
Zappitelli M, Moffett BS, Hyder A, Goldstein SL. Acute kidney injury in non-critically ill children treated with aminoglycoside antibiotics in a tertiary healthcare centre: A retrospective cohort study. Nephrol Dial Transplant. 2011;26:144-50.
The Turkish Society for Pediatric Nephrology Acute Kidney Injury Study Group, Duzova A, Bakkaloglu A, Kalyoncu M, Poyrazoglu H, Delibas A, et al. Etiology and outcome of acute kidney injury in children. PediatrNephrol 2010;25:1453-6.
Bowers LS, Wong ET. Kinetic serum creatinine assay II. A critical analysis and review.ClinChem 1980;26:555-61.
Cerdá J, BaggaA, Kher V, Chakravarthi RM. The contrasting characteristics of acute kidney injury in developed and developing countries. Nat ClinPractNephrol.2008;4:138-53.
Srivastava RN, Bagga A, Moudgil A. Acute renal failure in north Indian children. Indian J Med Res.1990;92:404-8.
- Abstract Viewed: 1078 times
- PDF Downloaded: 640 times