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Objective:Acute kidney injury is amajor contributor of morbidityand mortality inhospitalized children.Theaim of this study is to determine disease characteristicsincluding prevalence,etiology,distributionand treatment outcomes ofAKI in Chinesepaediatric patients.
Patientsand methods:Adatabase of paediatricAKI patients("18years)admitted tovarious paediatric wards,NICUand PICU of Tongji Hospital in Hubei Province inCentral Chinafrom January2009to December2013was retrospectivelyanalyzed.AKI was defined by theAcute Kidney Injury Network(AKIN)criteria.The cause ofAKI was definedas the major underlying disease.
Results:During the study period,42,684paediatric patients wereadmitted;1090fthese patients were diagnosed withAKI resulting inan overall prevalence of0.25％.The point prevalence decreased from0.42％in2009to0.12％in2013.The mean±SDage of the patients was82.7±54.8months,and the M:F ratio was l.5:1.Sevenchildren(6.4％)were"one month ofage,while102(93.6％)were>1month ofage.AKI was present in105(96.3％)childrenatadmission with49.5％havingAKI stage3(Failure).The mean length of hospital stay was17.0±10.4days(range:1-57days).IntrinsicAKIaccounted for80.7％of the cases,with prerenaland postrenal causesaccounting for16.5％and l.8％,respectively.The three most common causes ofAKIaccording to individual etiological disease were Nephrotic syndrome(20.2％),acuterenal failure(11.9％)and Henoch Schonlein PurpuraGlomerulonephritis(9.2％).Primary kidney disease categoryaccounted for49.5％.Neonatalasphyxiaand sepsiswere the common causes ofAKIamong the neonates.Case fatality rate was2.8％;thecauses of death were severe sepsisand shock(0.9％),central respiratory failure(0.9％)andacute left heart failure(0.9％).
Conclusion:There isageneral trend towardsadecrease in the point prevalence ofAKI from2009t02013;with the5-year prevalence of0.25％.The causes ofAKI inChinese paediatric patientsareage-related.Overall,primary renal disease is thecommon cause ofAKI,while sepsis is the least common.Acute kidney injury islife-threatening with highAKI-related mortality.
Patientsand methods:Adatabase of paediatricAKI patients("18years)admitted tovarious paediatric wards,NICUand PICU of Tongji Hospital in Hubei Province inCentral Chinafrom January2009to December2013was retrospectivelyanalyzed.AKI was defined by theAcute Kidney Injury Network(AKIN)criteria.The cause ofAKI was definedas the major underlying disease.
Results:During the study period,42,684paediatric patients wereadmitted;1090fthese patients were diagnosed withAKI resulting inan overall prevalence of0.25％.The point prevalence decreased from0.42％in2009to0.12％in2013.The mean±SDage of the patients was82.7±54.8months,and the M:F ratio was l.5:1.Sevenchildren(6.4％)were"one month ofage,while102(93.6％)were>1month ofage.AKI was present in105(96.3％)childrenatadmission with49.5％havingAKI stage3(Failure).The mean length of hospital stay was17.0±10.4days(range:1-57days).IntrinsicAKIaccounted for80.7％of the cases,with prerenaland postrenal causesaccounting for16.5％and l.8％,respectively.The three most common causes ofAKIaccording to individual etiological disease were Nephrotic syndrome(20.2％),acuterenal failure(11.9％)and Henoch Schonlein PurpuraGlomerulonephritis(9.2％).Primary kidney disease categoryaccounted for49.5％.Neonatalasphyxiaand sepsiswere the common causes ofAKIamong the neonates.Case fatality rate was2.8％;thecauses of death were severe sepsisand shock(0.9％),central respiratory failure(0.9％)andacute left heart failure(0.9％).
Conclusion:There isageneral trend towardsadecrease in the point prevalence ofAKI from2009t02013;with the5-year prevalence of0.25％.The causes ofAKI inChinese paediatric patientsareage-related.Overall,primary renal disease is thecommon cause ofAKI,while sepsis is the least common.Acute kidney injury islife-threatening with highAKI-related mortality.