Abstract
The purpose of our study was to apply the new classification criteria proposed by the Acute Kidney Injury Network (AKIN) in a pediatric population and to determine the clinical characteristics, laboratory features and outcomes of acute kidney injury (AKI) in a tertiary pediatric nephrology center in Turkey. Patients’ charts from January 2003 to August 2008 were retrospectively evaluated. One hundred patients (55 male; 45 female) were enrolled. Median age at the time of AKI was 7 years (range 1 month−18 years). Patients’ AKI was classified according to the staging system as follows: 25% stage 1, 36% stage 2 and 39% stage 3. The etiology of AKI was bone marrow transplantation related in 27%, renal disease in 14%, dehydration in 10%, nephrotoxic medication in 8%, cardiac surgery related in 8%, and congenital anomalies in 2%. Multiple etiologic factors with underlying chronic diseases were present in 31% of the patients. Dialysis was needed in 45% of the patients. Mortality rate was 33%. Dialysis need and mortality rate were higher in stage 2 and stage 3 patients, with a more favorable prognosis in stage 1 patients. Mortality rate was higher in patients that had undergone cardiac surgery and in those with multiple etiologic factors. The proposed AKIN staging successfully reflected the course of patients with AKI. The underlying cause of AKI seemed to be an important risk factor for death.
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Bagga A, Bakkaloğlu A, Deverajan P, Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Joannidis M, Levin A, Acute Kidney Injury Network (2007) Improving outcomes from acute kidney injury: report of an initiative. Pediatr Nephrol 22:1655–1658
Hui-Stickle S, Brewer ED, Goldstein S (2005) Pediatric ARF epidemiology at a tertiary care center from 1999 to 2001. Am J Kidney Dis 45:96–101
Anochie IC, Eke FU (2005) Acute renal failure in Nigerian children: Port Harcourt experience. Pediatr Nephrol 20:1610–1614
Vachvanichsanong P, Dissaneewate P, Lim A, McNeil E (2006) Childhood acute renal failure: 22 year experience in a university hospital in southern Thailand. Pediatrics 118:e786–e791
Assounga AG, Assambo-Kieli C, Mafouna A, Moyen G, Nzingoula S (2000) Etiology and outcome of acute renal failure in children in Congo-Brazzaville. Saudi J Kidney Dis Transpl 11:40–43
Otukesh H, Hoseini R, Hooman N, Chalian M, Chalian H, Tabarroki A (2006) Prognosis of acute renal failure in children. Pediatr Nephrol 21:1873–1878
Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A (2007) Acute Kidney Injury Network (AKIN): report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31
Davis ID, Avner ED (2007) Part XXII—nephrology section 1—glomerular disease. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds) Nelson’s textbook of pediatrics, 18th edn. Elsevier, Philadelphia, pp 2163–2167
Gökcay G, Emre S, Tanman F, Sirin A, Elcioglu N, Dolunay G (1991) An epidemiological approach to acute renal failure in children. J Trop Pediatr 37:191–193
Akcan-Arıkan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL (2007) Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 71:1028–1035
Loza R, Estremadoyro L, Loza C, Cieza J (2006) Factors associated with mortality in acute renal failure in children. Pediatr Nephrol 21:106–109
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Özçakar, Z.B., Yalçınkaya, F., Altas, B. et al. Application of the new classification criteria of the Acute Kidney Injury Network: a pilot study in a pediatric population. Pediatr Nephrol 24, 1379–1384 (2009). https://doi.org/10.1007/s00467-009-1158-1
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DOI: https://doi.org/10.1007/s00467-009-1158-1