+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: a prospective cohort study

, : Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: a prospective cohort study. American Journal of Kidney Diseases 59(4): 523-530

The development of standardized acute kidney injury (AKI) definitions has allowed for a better understanding of AKI epidemiology, but the long-term renal outcomes of AKI in the pediatric critical care setting have not been well established. This study was designed to: (1) determine the incidence of chronic kidney disease (CKD) in children 1-3 years after an episode of AKI at a tertiary-care pediatric intensive care unit (ICU), identify the proportion of patients at risk of CKD, and compare ICU admission characteristics in those with and without CKD. Prospective cohort study. & ParticipantsPatients admitted to the British Columbia Children's Hospital pediatric ICU from 26-28 with AKI, as defined by AKI Network (AKIN) criteria. Surviving patients, most with short-term recovery from their AKI, were assessed at 1, 2, or 3 years after AKI.PredictorsSeverity of AKI as defined by AKIN and several ICU admission characteristics, including demographics, diagnosis, severity of illness, and ventilation data.Outcomes & MeasurementsCKD was defined as the presence of albuminuria and/or glomerular filtration rate (GFR) <6 mL/min/1.73 m. Being at risk of CKD was defined as having a mildly decreased GFR (6-9 mL/min/1.73 m), hypertension, and/or hyperfiltration (GFR ?15 mL/min/1.73 m). The proportion of patients with AKI stages 1, 2, and 3 were 44 of 126 (35%), 47 of 126 (37%), and 35 of 126 (28%), respectively. The number of patients with CKD 1-3 years after AKI was 13 of 126 (1.3% overall; 2 of 44 [4.5%] with stage 1, 5 of 47 [1.6%] with stage 2, and 6 of 35 [17.1%] with stage 3;P= .2). In addition, 59 of 126 (46.8%) patients were identified as being at risk of CKD.LimitationsSeveral patients identified with AKI were lost to follow-up, with the potential of underestimating the incidence of CKD. In tertiary-care pediatric ICU patients, ?1% develop CKD 1-3 years after AKI. The burden of CKD in this population may be higher with further follow-up because several patients were identified as being at risk of CKD. Regardless of the severity of AKI, all pediatric ICU patients should be monitored regularly for long-term kidney damage.


PMID: 22206744

DOI: 10.1053/j.ajkd.2011.10.048

Other references

Szlachta, J., 1985: Effect of geometrical and mechanical parameters of the teat liner on the intensity of teat massage. The complex relationship between pressure applied to the teat during machine milking, and teatcup liner tension, elasticity and inner diam. is analysed. The effect of different udder and teat shapes and teat length on tension measurements is discu...

Brooks, W.K., 1895: Science Or Poetry. Science 2(40): 437-440

Kurimoto, M.; Endo, S.; Ohi, M.; Hirashima, Y.; Matsumura, N.; Takaku, A., 1998: Pyogenic osteomyelitis of an invaginated odontoid process with rapid deterioration of high cervical myelopathy: A case report. Acta Neurochirurgica 140(10): 1093-1094

Pepperberg, I.M.; Brezinsky, M.V., 1991: Acquisition of a relative class concept by an African gray parrot (Psittacus erithacus): discriminations based on relative size. We report that an African gray parrot (Psittacus erithacus), Alex, responds to stimuli on a relative basis. Previous laboratory studies with artificial stimuli (such as pure tones) suggest that birds make relational responses as a secondary strate...

Louis, M.R.; Meaike, J.D.; Chamata, E.; Hollier, L.H., 2016: Practical Considerations in Pediatric Surgery. NlmCategory="UNASSIGNED">The care of pediatric patients requires special considerations that are often not addressed in the literature. Relatively straightforward tasks such as clinical evaluation, antibiotic use, splinting, wound clo...

Tannenbaum, J.; Tanenbaum, S.W.; Godman, G.C., 1977: The binding sites of cytochalasin d part 2 their relationship to hexose transport and to cytochalasin b. Cytochalasin B (CB) was able to compete with 3H cytochalasin D (3H-CD) for binding sites in HEp-2 [human laryngeal carcinoma] cells. The pattern of inhibition suggested that CB associates with a low affinity class of CD binding sites. Glucose and...

Crockett, C.O.; Guede-Guina, F.; Pugh, D.; Vangah-Manda, M.; Robinson, T.J.; Olubadewo, J.O.; Ochillo, R.F., 1992: Cassia alata and the preclinical search for therapeutic agents for the treatment of opportunistic infections in AIDS patients. In our search for therapeutic agents from natural sources with potential for the treatment of opportunistics infections in patients afflicted with acquired immunodeficiency syndrome (AIDS), we investigated antibacterial and antifungal activities o...

Butnick N.J.; Miyamoto C.; Chizzonite R.; J.G.; Skalka A.M., 1984: Transcriptional and translational control of c myc expression in hl 60 cells. Journal of Cellular Biochemistry Supplement (8 PART A): 83

Ray, D.E., 2005: CINP 2000 - Collegium Internationale Neuro-Psychopharmacologicum 22nd Congress. At this large and varied meeting on neuropharmacotherapy, progress was reported on the newer more selective antipsychotics. The selective D(2) dopamine receptor partial agonist, aripiprazole (Otsuka Pharmaceutical Co Ltd) was recently proved effec...

Takai, E.; Yano, T.; Iguchi, H.; Fukuyama, Y.; Yokoyama, H.; Asoh, H.; Ichinose, Y., 1996: Tumor-induced hypercalcemia and parathyroid hormone-related protein in lung carcinoma. BACKGROUND: Although lung carcinoma is the most common cause of tumor-induced hypercalcemia (TIH), the precise incidence of TIH remains obscure. Furthermore, the role of parathyroid hormone-related protein (PTHrP) has not been clearly elucidated....