title: Clinical characteristics and mortality risk prediction in children with acute kidney injury.
abstract: BACKGROUND
  Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately.
  
  
  OBJECTIVE
  AKI is a serious condition in critically ill patients. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of AKI in the Pediatric Intensive Care Unit (PICU).
  
  
  METHODS
  This prospective observational study was conducted in the PICU of a hospital in the South-east Area of Iran (Zahedan City), to study the clinico-etiological profile of AKI (defined according to the AKI network criteria). Over a period of 20 months from April 2012 to December 2014, 303 children were included in the study. Both the groups of patients, those who developed AKI and those who did not develop AKI, were then followed during the course of their hospital stay.
  
  
  RESULTS
  There were 303 cases included in the study, with the incidence rate of AKI of 14.9% in PICU. The most common PICU admission diagnoses in AKI were neurologic 85 (%28.05), followed by heart diseases 52 (17.18%) and 31 (10.23%) for respiratory diseases. AKI was 43.5 and 5.4 times more prevalent in renal and endocrine patients compared to those with heart disease respectively. The mortality rate was estimated to be higher in patients with AKI compared to their counterparts (40% vs. 17.8%). Chance of death increased in patients with AKI (odds ratio = 3.04).
  
  
  CONCLUSIONS
  AKI is a serious problem, but its true incidence is unknown. Understanding the epidemiology of AKI by using of standard definition help us to find high-risk children that are the first step to improve outcomes. The future multiple-center study may benefit by better identifying risk factors and early detection of AKI by using biomarkers novel to prevent the developing of AKI.
authors.affiliation: Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Simin
authors.initials: S
authors.lastname: Sadeghi-Bojd
authors.affiliation: Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Noor Mohammad
authors.initials: NM
authors.lastname: Noori
authors.affiliation: Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohammadi
authors.affiliation: Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Teimouri
keywords: Acute kidney injury; Pediatric Intensive Care Unit; children