title: Pediatric Risk, Injury, Failure, Loss, End-Stage renal disease score identifies acute kidney injury and predicts mortality in critically ill children: a prospective study.
abstract: OBJECTIVE
  To determine whether Pediatric Risk, Injury, Failure, Loss, End-Stage renal disease (pRIFLE) criteria serve to characterize the pattern of acute kidney injury in critically ill pediatric patients. To identify if pRIFLE score will predict morbidity and mortality in our patient's cohort.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  Multidisciplinary, tertiary care, ten-bed PICU.
  
  
  METHODS
  A total of 266 patients admitted to PICU from November 2009 to November 2010.
  
  
  METHODS
  None.
  
  
  RESULTS
  The incidence of acute kidney injury in the PICU was 27.4%, of which 83.5% presented within 72 hours of admission to the PICU. Patients with acute kidney injury were younger; weighed less; were more likely to be on fluid overload greater than or equal to 10%; and were more likely to be on inotropic support, diuretics, or aminoglycosides. No difference in gender, use of other nephrotoxins, or mechanical ventilation was observed. Fluid overload greater than or equal to 10% was an independent predictor of morbidity and mortality. In multivariate analysis, acute kidney injury and failure categories, as defined by pRIFLE, predicted mortality, hospital length of stay, and PICU length of stay.
  
  
  CONCLUSIONS
  In this cohort of critically ill pediatric patients, acute kidney injury identified by pRIFLE and fluid overload greater than or equal to 10% predicted increased morbidity and mortality. Implementation of pRIFLE scoring and close monitoring of fluid overload upon admission may help develop early interventions to prevent and treat acute kidney injury in critically ill children.
authors: Department of Pediatric Critical Care, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico. ysoler@hotmail.com
authors: Yadira A
authors: YA
authors: Soler
authors: Mariely
authors: M
authors: Nieves-Plaza
authors: Mónica
authors: M
authors: Prieto
authors: Ricardo
authors: R
authors: García-De Jesús
authors: Marta
authors: M
authors: Suárez-Rivera
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000652:urine; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality; D005260:Female; D005544:Forecasting; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014556:Urine; D055815:Young Adult
chemical_list: D003404:Creatinine