Incidence, risk factors and outcome of acute kidney injury in critically ill children – a developing country perspective

Background: Acute kidney injury (AKI) is common in critically ill children and is associated with poor outcome.Objective: To study the incidence, risk factors and outcome of AKI in children admitted to paediatric intensive care unit (PICU) of a developing country.Materials and Methods: This prospective observational study was conducted in a tertiary care PICU over one-year period. Critically ill children aged from 2 months to 18 years were included. RIFLE criteria based on GFR, and urine output was used for categorisation.Results: Of 380 children, 53 children (14%) had AKI (met any of the RIFLE criteria). The most common diagnoses underlying AKI were acute lower respiratory tract infection, CNS illness and severe dehydration. Subjects with AKI had a higher PRISM score (>10) at admission, longer duration of stay and high mortality. Significant risk factors for AKI following multivariate analysis were: age 1–5, PRISM score (>10) at admission, shock, infection, thrombocytopenia, hypo-albuminaemia and multi-o...