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Acute kidney injury requiring dialysis in children: a multicentric, emerging country perspective.
- Source :
-
Pediatric Nephrology . Jul2024, Vol. 39 Issue 7, p2253-2262. 10p. - Publication Year :
- 2024
-
Abstract
- Background: Acute kidney injury (AKI) is a life-threatening condition, especially in extreme age groups and when kidney replacement therapy (KRT) is necessary. Studies worldwide report mortality rates of 10–63% in pediatric patients undergoing KRT. Methods: Over 13 years, this multicenter study analyzed data from 693 patients with AKI, all receiving KRT, across 74 hospitals and medical facilities in Rio de Janeiro, Brazil. Results: The majority were male (59.5%), under one year old (55.6%), and treated in private hospitals (76.5%). Sixty-six percent had comorbidities. Pneumonia and congenital heart disease were the most common admission diagnoses (21.5% and 20.2%, respectively). The mortality rate was 65.2%, with lower rates in patients over 12 years (50%). Older age was protective (HR: 2.35, IQR [1.52–3.62] for neonates), and primary kidney disease had a three-fold lower mortality rate. ICU team experience (HR: 0.74, IQR [0.60–0.91]) correlated with lower mortality, particularly in hospitals treating 20 or more patients. Among the deceased, 40% died within 48 h of KRT initiation, suggesting possible late referral or treatment futility. Conclusions: This study confirms the high mortality in pediatric dialytic AKI in middle-income countries, underlining early mortality and offering critical insights for improving outcomes. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PNEUMONIA
*CONGENITAL heart disease
*MIDDLE-income countries
*THERAPEUTICS
*RENAL replacement therapy
*ACUTE kidney failure
*HEMODIALYSIS
*CATASTROPHIC illness
*DESCRIPTIVE statistics
*CAUSES of death
*AGE distribution
*PEDIATRICS
*RESEARCH
*HEALTH equity
*COMORBIDITY
*LOW-income countries
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 0931041X
- Volume :
- 39
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Pediatric Nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 177623352
- Full Text :
- https://doi.org/10.1007/s00467-024-06305-9