Clinicoetiological profile of acute kidney injury in paediatric intensive care unit patients

Vidya Krishnamurthy, Anil Shetty K., Jaidev M. D.


Background:Acute kidney injury (AKI) is common in patients in the paediatric intensive care unit and is associated with poor outcome. Present study was conducted to determine the occurrence, risk factors and etiology of AKI in the PICU.

Methods: Data was collected retrospectively from case records of children admitted to PICU during one year.AKI was defined and classified according to modified pRIFLE (risk injury failure loss end stage renal disease) criteria.

Results:227 children were included in the study, 31(13.6%) developed AKI, of these 16 (51.6%) had risk, 11 (35.4%) had injury and 4 (12.9%) had failure. Overall mortality was 32.3%. 83.9% of AKI was in the age group of < 5 years. Sepsis (22.9%) was the most common etiology.

Conclusions:AKI is common in children admitted to PICU. In our present study we found that hypoxia was the major risk factor for AKI followed by nephrotoxic drugs and hypotension. Females had a higher occurrence of AKI. Sepsis was found to be the commonest etiology. Greater the category of the AKI, higher was the mortality.  


Acute kidney injury, Hypoxia, pRIFLE, Sepsis

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Case J, Khan S, Khalid R, Khan A. Epidemiology of acute kidney injury in the intensive care unit. Critic Care Res Practice. 2013;2:1-9.

Hui WF, Chan WK, Miu TY. Acute kidney injury in the paediatric intensive care unit: identification by modified RIFLE criteria. Hong Kong Med J. 2013;19(1):13-9.

Arikan A, Zappitelli M, Loftis L, Washburn K, Jefferson L, Goldstein S. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007;71(10):1028-35.

Bagga A, Srivatsava RN. Textbook of paediatric nephrology, 5th edition. New Delhi. Jaypee Brothers. 2011:34.

Glodstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pedia Critic Care Med. 2005;6(1):96.

Narayanan P, Prabha S, Mondal N, Mahadevan S, Srinivasan S, Krishnamurthy S et al. Clinical profile of acute kidney injury in a pediatric intensive care unit from Southern India: a prospective observational study. Indian J Critical Care Med. 2013;17(4):207.

Naik S, Sharma J, Yengkom R, Kalrao V, Mulay A. Acute kidney injury in critically ill children: Risk factors and outcomes. Indian J Critical Care Med. 2014;18(3):129.

Mehta P, Sinha A, Sami A, Hari P, Kalaivani M, Gulati A et al. Incidence of acute kidney injury in hospitalized children. Indian Pedia. 2011;49(7):537-42.

Bailey D, Phan V, Litalien C. Risk factors of acute renal failure in critically ill children: a prospective descriptive epidemiological study. Pediatr Crit Care Med. 2007;8:29-35.