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Clinical Profile and Outcome of Emergencies in Pediatric Chronic Kidney Disease

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Abstract

Objective

To describe the clinical profile and outcome of emergencies in children with chronic kidney disease (CKD).

Methods

This retrospective analysis studied children with CKD presenting with acute emergencies. The clinical profile, renal and patient outcomes were compared between incidentally diagnosed - iCKD, previously diagnosed not on dialysis - pCKD and those on maintenance dialysis - dCKD groups.

Results

82 children (67 boys, median age - 8 years) with 99 visits were included. Uremic encephalopathy was the most common emergency in iCKD (64.7%) and pCKD (38.4 %), and access-related infections (32.1%) in dCKD group. Children with iCKD had higher Pediatric Risk of Mortality score (P<0.001), emergent initiation of dialysis (P=0.03) and discontinuation of treatment (P<0.001) when compared to the pCKD group.

Conclusion

Uremic encephalopathy and access-related infections were the most common emergencies in children with CKD. Incidentally diagnosed CKD had a worse clinical profile and outcome.

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Funding

Funding: None

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Authors and Affiliations

  1. Department of Pediatric Nephrology, St John’s Medical College Hospital, Bengaluru, Karnataka, India

    Mohammed Azarudeen,  Nivedita Kamath & Anil Vasudevan

  2. Department of Pediatric Intensive Care, St John’s Medical College Hospital, Bengaluru, Karnataka, India

    A. V. Lalitha

Authors
  1. Mohammed Azarudeen
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  2. Nivedita Kamath
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  3. A. V. Lalitha
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  4. Anil Vasudevan
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Contributions

Contributions: MA: data collection, analysis of the data and writing of the manuscript; NK: study design, supervision of data collection and analysis and writing of the manuscript; LAV: study design, analysis of data and writing of the manuscript; AV: writing of the manuscript and critical review of the manuscript. All authors approved the final draft of the manuscript.

Corresponding author

Correspondence to Nivedita Kamath.

Ethics declarations

Ethics clearance: Institutional Ethics Committee, St John’s Medical College, Bengaluru; No. 350/2018, dated Nov. 29, 2018.

Competing interests: None stated.

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Azarudeen, M., Kamath, N., Lalitha, A.V. et al. Clinical Profile and Outcome of Emergencies in Pediatric Chronic Kidney Disease. Indian Pediatr 59, 31–34 (2022). https://doi.org/10.1007/s13312-022-2416-6

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  • DOI: https://doi.org/10.1007/s13312-022-2416-6

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