Etiology and Outcome of Acute Kidney Injury in Children: The South Asian Experience With Special Reference to Bangladesh Acute Kidney Injury in Children
Journal of Pediatric Nephrology,
Vol. 13 (2025),
12 May 2026
https://doi.org/10.22037/jpn.v13i1.48028
Abstract
Background and Aim: Pediatric acute kidney injury (AKI)’s incidence, etiology, and
outcomes are very diverse and influenced by factors, such as age, location, and clinical
situation. Emphasizing regional epidemiology and its underlying causes is crucial for
improving the identification and management of this insidious issue.
Methods: This retrospective study was done at the Pediatric Nephrology Department
of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, a
developing country in South Asia. It included AKI patients aged 28 days to 18 years who
attended outpatient and inpatient departments between July 1, 2022, and August 31, 2024.
Results: In a 24-month span, 356(27.05%) instances of AKI were detected, with 5 to 15
years (55.06%) being the most prevalent age range. The etiology of AKI was identified to be
prerenal in 154 cases (46.26%), renal in 170 instances (47.75%), and postrenal in 32 cases
(8.98%). Of the total number of patients, 290(81.46%) were managed with conservative
treatment, while 20(5.62%) required hemodialysis and 46(12.92%) required peritoneal
dialysis. Over a three-month period, 302 children (84.83%) remained alive, with 17(4.78%)
developing CKD, 22(6.18%) developing end-stage renal disease (ESRD), and 15(4.21%)
passed away (P<0.0001). The presence of anuria, volume overload, and primary renal
disease were identified as significant risk factors for beginning renal replacement therapy
(hemodialysis and peritoneal dialysis).
Conclusion: Pediatric AKI is mainly caused by gastroenteritis, sepsis, and rapidly progressive
glomerulonephritis (RPGN), which recover well at a single tertiary care center. Oliguria/
anuria, anemia, volume overload, failure (pRIFLE category) at presentation, and dialysis
necessity were correlated with unfavorable renal outcomes.
- Acute kidney injury (AKI)
- Pediatrics
- Epidemiology
- Outcome
How to Cite
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