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Long-term kidney outcomes in children following continuous kidney replacement therapy.
- Source :
- Pediatric Nephrology; Feb2023, Vol. 38 Issue 2, p565-572, 8p, 1 Diagram, 1 Chart, 3 Graphs
- Publication Year :
- 2023
-
Abstract
- Background: Continuous kidney replacement therapy (CKRT) is a mainstay of therapy for management of severe acute kidney injury (AKI) in critically ill pediatric patients. There is limited data on the risk of chronic kidney disease (CKD) after discharge in this population. Methods: This is a single-center, retrospective cohort study of all pediatric patients ages 0–17 years who received CKRT from 2013 to 2017. The study excluded patients with pre-existing CKD, those who died prior to discharge, and those who had insufficient follow-up data. Patients were followed after hospital discharge and electronic health record data was collected and analyzed to assess for incidence of and risk factors for kidney sequelae. Results: A total of 42 patients were followed at a median time of 27 months (IQR 17.2, 39.8). Of these, 26.2% had evidence of CKD and 19% were at risk for CKD. Lower eGFR at hospital discharge was associated with increased odds of kidney sequelae (aOR 0.985; 95% CI 0.972, 0.996). Ages 0– < 1 and 12–17 were not significantly different (aOR 0.235, 95% CI 0.024, 1.718) and had the highest incidence of kidney sequelae (50% and 77%, respectively). Ages 1–5 and 6–11 had a decreased odds of kidney sequelae compared to the 12–17 year age group (aOR 0.098; 95% CI 0.009, 0.703 and aOR 0.035; 95% CI 0.001, 0.39, respectively). Only 54.8% of patients (n = 23) were seen in the nephrology clinic after discharge. Conclusions: Patients who receive CKRT for AKI have a significant risk of CKD, while follow-up with a pediatric nephrologist in these high-risk patients is sub-optimal. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]
- Subjects :
- EVALUATION of medical care
CHRONIC kidney failure
CONFIDENCE intervals
CRITICALLY ill
PATIENTS
RETROSPECTIVE studies
ACQUISITION of data
RISK assessment
TREATMENT effectiveness
MEDICAL records
DESCRIPTIVE statistics
HEMODIALYSIS
ELECTRONIC health records
ODDS ratio
ACUTE kidney failure
DISCHARGE planning
DISEASE risk factors
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 0931041X
- Volume :
- 38
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Pediatric Nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 160868323
- Full Text :
- https://doi.org/10.1007/s00467-022-05579-1