Acute kidney injury in pediatric patients: experience of a single center during an 11-year period.
The aim of our study was to determine the causes of acute kidney injury (AKI) in children, to compare outcomes between two periods--1998-2003 and 2004-2008--and to evaluate the influence of new methods of renal replacement therapy on mortality.


METHODS
A retrospective analysis of medical record data of all children treated for AKI at the Clinic of Children Diseases, Hospital of Kaunas University of Medicine, during the period of 1998-2008 was made. Both periods were compared regarding various variables.


RESULTS
Of the 179 children with AKI, 75 (41.9%) were treated during 1998-2003 and 104 (58.1%) during 2004-2008. Primary glomerular disease and sepsis were the leading causes of AKI in both the periods. AKI without involvement of other organs was diagnosed for 106 (59.2%) children: for 42 (56.0%) children in the first period and 64 (61.5%) in the second. A total of 124 (69.3%) children were treated in a pediatric intensive care unit. Multiple organ dysfunction syndrome with AKI was diagnosed for 33 (44%) patients in the first period and for 40 (38.5%) in the second. A significant decrease in mortality among patients with multiple organ dysfunction syndrome during the second period was observed (78.8% vs. 37.5%).


CONCLUSIONS
More than half of patients had secondary acute kidney injury of nonrenal origin. More than two-thirds (69.3%) of patients with AKI were treated in the pediatric intensive care unit. Multiple organ dysfunction syndrome was diagnosed for 40.8% of children with AKI. Renal replacement therapy was indicated for one-third of patients with AKI. A 2.5-fold decrease in mortality was observed in the second period as compared to the first one.
Pundzienė
Birutė
B
Department of Children's Diseases, Kaunas University of Medicine, Eivenių 2, 50028 Kaunas, Lithuania.
Dobilienė
Diana
D
Rudaitis
Sarūnas
S
D058186:Acute Kidney Injury / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000628:therapy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006753:Hospital Records; D006801:Humans; D015994:Incidence; D007223:Infant; D007362:Intensive Care Units; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008499:Medical Records; D009102:Multiple Organ Failure / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome