title: Incidence and Outcome of Acute Cardiorenal Syndrome in Hospitalized Children.
abstract: OBJECTIVE
  To determine the incidence, etiology and outcome of Cardiorenal syndrome (CRS) in hospitalized children.
  
  
  METHODS
  A prospective cohort study was carried out in 242 children between 6 mo to 18 y of age hospitalized with primary cardiac, renal or any systemic disorder at a tertiary care center in India. The primary outcome was the development of CRS. Univariate and multivariate logistic regression analysis were performed to determine the risk of mortality secondary to CRS.
  
  
  RESULTS
  Among 242 children, 67 (27.7%) children developed CRS and the rest 175 (72.3%) did not. Among those with CRS, 40.3%, 20.9%, and 38.8% had CRS-1, 3 and 5, respectively. Cardiac diseases leading to CRS were myocarditis (40.7%) followed by congenital heart disease (25.9%), rheumatic heart disease (18.5%), and dilated cardiomyopathy (7.4%); renal disease associated with CRS was acute glomerulonephritis (100%) and major systemic disorders leading to CRS were septicemia (53.8%), malaria (23.1%), scrub typhus (7.7%), and acute gastroenteritis (3.8%). The occurrence of CRS was associated with an increased risk of mortality (OR 6.3, 95% CI: 2.8, 14.1; p 0.000). A subgroup analysis revealed that children with CRS having acute kidney injury stage 2 and 3 also had a higher risk of mortality (p 0.001).
  
  
  CONCLUSIONS
  The incidence of CRS is quite high in children with cardiac, renal or systemic diseases and is associated with a significant risk of mortality. Children presenting with these illnesses should be monitored for the occurrence of CRS so that early intervention may reduce mortality.
authors.affiliation: Department of Pediatric Medicine, Division of Pediatric Nephrology, SMS Medical College, Jaipur, Rajasthan, 302004, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Athwani
authors.affiliation: Department of Pediatric Medicine, Division of Pediatric Nephrology, SMS Medical College, Jaipur, Rajasthan, 302004, India.
authors.forename: Maneesha
authors.initials: M
authors.lastname: Bhargava
authors.affiliation: Division of Pediatric Nephrology, McMaster Children's Hospital, McMaster University, Hamilton, ON, Canada.
authors.forename: Rahul
authors.initials: R
authors.lastname: Chanchlani
authors.affiliation: Department of Pediatric Medicine, Division of Pediatric Nephrology, SMS Medical College, Jaipur, Rajasthan, 302004, India. dramarjeetmehta@yahoo.com.
authors.forename: Amar Jeet
authors.initials: AJ
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D059347:Cardio-Renal Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D015994:Incidence; D007223:Infant; D007674:Kidney Diseases / Q000150:complications; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Acute decompensated heart failure; Acute kidney injury; Cardiorenal syndrome