Prevalence of acute kidney injury in the paediatric intensive care unit at Pelonomi Regional Hospital

Abstract

Background Acute kidney injury (AKI) is common in critically ill children and associated with an increased mortality rate. This study aimed to determine the prevalence of AKI in critically ill children admitted to the paediatric intensive care unit at Pelonomi Hospital, the most common admission diagnoses among these patients admitted with AKI and the mortality rate in this cohort. Method A retrospective observational study design was followed. The study milieu was a 5-bed tertiary paediatric intensive care unit at Pelonomi Hospital in Bloemfontein. All patients between one month and thirteen years old admitted to the paediatric intensive care unit for the period 1 January 2015 to 31 December 2015 were screened for AKI. The clinical and laboratory features of the included children were recorded and used to diagnose AKI utilizing both the serum creatinine and urine output criteria of the paediatric Risk, Injury, Failure, End-stage and Failure classification (pRIFLE). Results The clinical records of 245 patients were evaluated, of these, 35 had to be excluded. Acute kidney injury was found in 108 (51.4%) of the remaining 210 patients. Of these 108 patients with AKI, 32 (29.6%) patients reached pRIFLE maximum of Risk, 30 (27.7%) patients reached Injury, and 46 (42.5%) had Failure. The most common admission diagnoses in children with AKI were pneumonia (30.5%) and acute diarrhoeal disease (16.7%). A total of 30 (14.2%) deaths occurred during the study period and AKI was present in 20 (18.5%) of these deaths. Conclusion Acute kidney injury is common in the paediatric intensive care. The most common admission diagnoses of the children found to have AKI were infective diseases like pneumonia and acute diarrhoea. Critically ill children have an increased risk for mortality.