Risk Factors and Prognostic Factors of Acute Kidney Injury in Children： a Retrospective Study between 2003 and 2013

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 35; no. 6; pp. 785 - 792
• Main Authors: Zhou, Yan-mei, Yin, Xiao-ling, Huang, Zhi-bin, He, Yong-hua, Qiu, Li-ru, Zhou, Jian-Hua
• Format: Journal Article
• Language: English
• Published: Wuhan Huazhong University of Science and Technology 01-12-2015; Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
• Subjects: Acute Kidney Injury - epidemiology; Adolescent; Child; Child, Preschool; China - epidemiology; Female; Humans; Infant; Infant, Newborn; Male; Medicine; Medicine & Public Health; Prognosis; Retrospective Studies; Risk Factors; 儿童医院; 危险因素; 年龄相关; 急性; 放射免疫分析; 肾损伤; 预后; 风险因素; China; epidemiology; risk factors; acute kidney injury; prognostic factors; children
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-015-1508-0

Summary： Recent report on epidemiology of acute kidney injury （AKI） is lacking for Chinese children. We aimed to investigate the risk factors for stage and prognostic factors for renal recovery in hospital- ized children. Pediatric patients （〈18 years old） admitted during 2003 to 2013 were enrolled in this study. AKI was defined and staged using Kidney Disease Improving Global Outcomes （KDIGO） crite- ria. Logistic regression analysis was performed to determine the risk factors and prognostic factors. The morbidity of pediatric AKI was 0.31% （205/65 237）. There were 45 （22.0%） cases in stage I, 30 （14.6%） cases in stage II and 130 （63.4%） cases in stage Ill. The majority of etiologies were intrinsic renal defects （85.4%）. Age, weight, vomit, etiology, blood urea nitrogen （BUN） at admission and sev- eral blood gas measurements were associated with AKI stage III. Age （OR=0.894; 95% CI, 0.832- 0.962; P=0.003）, vomit （OR=2.375; 95% CI, 1.058-5.333; P=0.036） and BUN at admission （OR=1.135;95% CI, 1.085-1.187; P〈0.001） were identified as independent risk factors for AKI stage Ill. After treatment, 172 （83.9%） patients achieved complete or partial recovery. The mortality was 3.9%. Variables were found as prognostic factors for renal recovery, such as age, stage, hospital stay, BUN at discharge, white blood cells, red blood cells, platelets （PLTs）, blood pH and urine blood. Among them, AKI stage（stage III vs. stage I ; OR, 6.506; 95% CI, 1.640-25.816; P=0.008）, BUN at discharge （OR, 0.918; 95% CI, 0.856-0.984; P=0.016） and PLTs （OR, 1.007; 95% CI, 1.001- 1.013; P=0.027） were identified as independent prognostic factors. AKI is still common in Chinese hos- pitalized children. Identified risk factors and prognostic factors provide guiding information for clinical management of AKI.