Background: Acute kidney injury is characterized by sudden and generally revertible renal function impairment involving inability to maintain homeostasis. In pediatrics, the main causes of acute kidney injury are sepsis, use of nephrotoxic drugs and renal ischemia in critically ill patients. The incidence of acute kidney injury in these patients ranges from 20 to 30%, resulting in increased morbid-mortality, a 40 to 90% rate. Objectives: This study aimed to evaluate the incidence of acute kidney injury in intensive care unit patients, to categorize the severity of the acute kidney injury according to the Pediatric Risk (R), Injury (I), Failure (F), Loss, End-Stage (pRIFLE), and to analyze outcome predictors. Methods: A prospective study of the patients admitted to the pediatric intensive care unit of Benha University Hospital was conducted between June 2012 and July 2013. Patients were evaluated daily for urine output and serum creatinine, and the patients were categorized according to the pRIFLE criteria. Results: During the follow-up period, 241 children were admitted, 61 patients were excluded due to exclusion criteria. The incidence of acute kidney injury was 61 cases out of 180 cases (33%), and the maximal pRIFLE score during hospitalization was 36% for (R), 44% for (I) and 20% for (F). The mortality rate was 34.4% in AKI cases. Patients with acute kidney injury had a twice times higher risk of death versus the not exposed patients. Conclusions: Acute kidney injury is frequent in critically ill patients. Early diagnosis and prompt and appropriate therapy for each clinical aspect may change this condition’s course and severity, and reduce the patients’ morbidity and mortality. |
