Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 18 , ISSUE 3 ( March, 2014 ) > List of Articles


Acute kidney injury in critically ill children: Risk factors and outcomes

Shweta Naik, Rameshwor Yengkom, Vijay Kalrao, Atul Mulay

Keywords : Acute kidney injury, pediatric intensive care unit, pRIFLE, PRISM III, sepsis

Citation Information : Naik S, Yengkom R, Kalrao V, Mulay A. Acute kidney injury in critically ill children: Risk factors and outcomes. Indian J Crit Care Med 2014; 18 (3):129-133.

DOI: 10.4103/0972-5229.128701

License: CC BY-ND 3.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2014; The Author(s).


Background: Acute kidney injury (AKI) is common in patients in the pediatric intensive care unit (PICU) and is associated with poor outcome. We conducted the present study to determine the incidence, risk factors and outcomes of AKI in the PICU. Materials and Methods: We collected data retrospectively from case records of children admitted to the PICU during one year. We defined and classified AKI according to modified pRIFLE criteria. We used multivariate logistic regression to determine risk factors of AKI and association of AKI with mortality and morbidity. Results: Of the 252 children included in the study, 103 (40.9%) children developed AKI. Of these 103 patients with AKI, 39 (37.9%) patients reached pRIFLE max of Risk, 37 (35.9%) patients reached Injury, and 27 (26.2%) had Failure. Mean Pediatric Risk of Mortality (PRISM III) score at admission was higher in patients with AKI than in controls (P < 0.001).

PDF Share
  1. Plotz FB, Bouma AB, Van Wijk JA, Kneyber MC, Bokenkamp A. Pediatric acute kidney injury in the ICU: An independent evaluation of pRIFLE criteria. Intensive Care Med 2008; 34:1713-17.
  2. Nasir SA, Bhat MA, Hijaz SW, Charoo BA, Sheikh BA. Profile of acute renal failure in children in Kashmir. Indian Pediatr 2011;48:491-2.
  3. Agarwal I, Kirubakaran C, Markandeyulu V. Clinical profile and outcome of acute renal failure in South Indian children. J Indian Med Assoc 2004;102:353-6.
  4. Kandoth PW, Agarwal GJ, Dharnidharka VR. Acute renal failure in children requiring dialysis therapy. Indian Pediatr 1994;31:305-9.
  5. Mehta P, Sinha A, Sami A. Incidence of acute kidney injury in hospitalized children. Indian Pediatr 2012;49:537-42.
  6. 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.
  7. Williams DM, Sreedhar SS, Mickell JJ, Chan JC. Acute kidney failure: A pediatric experience over 20 years. Arch Pediatr Adolesc Med 2002;156:893-900.
  8. Andreoli SP. Acute renal failure. Curr Opin Pediatr 2002;14:183-8.
  9. Chan JC, Williams DM, Roth KS. Kidney failure in infants and children. Pediatr Rev 2002;23:47-60.
  10. Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007;71:1028-35.
  11. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987;34:571-90.
  12. Zappitelli M, Parikh CR, Akcan-Arikan A, Washburn KK, Moffett BS, Goldstein SL. Ascertainment and epidemiology of acute kidney injury varies with definition interpretation. Clin J Am Soc Nephrol 2008;3:948-54.
  13. Pollack MM, Patel KM, Ruttimann UE. PRISM III: An updated pediatric risk of mortality score. Crit Care Med 1996;24:743-52.
  14. Liano F, Pascual J. Epidemiology of acute renal failure: A prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996;50:811-8.
  15. Schneider J, Khemani R, Grushkin C, Bart R. Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit. Crit Care Med 2010;38:933-9.
  16. Proulx F, Fayon M, Farrell CA, Lacroix J, Gauthier M. Epidemiology of sepsis and multiple organ dysfunction syndrome in children. Chest 1996;109:1033-7.
  17. Park WY, Hwang EA, Jang MH, Park SB, Kim HC. The risk factors and outcome of acute kidney injury in the intensive care units. Korean J Intern Med 2010;25:181-7.
  18. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.