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Clinical profile of acute kidney injury in a pediatric intensive care unit from Southern India: A prospective observational study.
[scrub typhus]
Although
the
term
acute
renal
failure
was
replaced
by
acute
kidney
injury
(
AKI
)
recently
,
there
is
a
paucity
of
data
on
the
incidence
and
profile
of
AKI
in
critically
ill
children
from
the
developing
world
.
The
objective
of
this
study
is
to
determine
the
incidence
,
etiology
,
short
term
outcome
and
predictors
of
fatality
in
critically
ill
children
admitted
to
the
pediatric
intensive
care
unit
(
PICU
)
with
AKI
,
aged
1
month
to
13
years
.
In
this
prospective
observational
study
,
from
June
2010
to
March
2011
,
215
children
admitted
to
the
PICU
were
screened
for
AKI
,
defined
according
to
the
AKI
Network
criteria
.
The
patients
with
AKI
were
followed-up
until
discharge
/
death
.
Their
clinical
and
biochemical
data
were
recorded
.
The
incidence
of
AKI
among
215
patients
screened
was
54
(
25
.
1
%
)
.
The
common
etiologies
were
infections
,
[
34
(
62
.
9
%
)
]
,
acute
glomerulonephritis
(
7
.
6
%
)
,
snake
envenomation
(
5
.
7
%
)
,
hemolytic
uremic
syndrome
(
3
.
8
%
)
and
congestive
cardiac
failures
(
3
.
8
%
)
.
Among
infections
,
pneumonia
and
septicemia
constituted
26
.
5
%
each
,
meningoencephalitis
accounted
for
23
.
5
%
,
and
dengue
,
scrub
typhus
,
tuberculosis
and
malaria
constituted
9
.
3
%
of
children
with
AKI
.
27
.
8
%
of
patients
required
dialysis
.
Overall
mortality
was
46
.
3
%
.
On
logistic
regression
analysis
,
requirement
of
mechanical
ventilation
was
an
independent
predictor
of
fatality
in
AKI
.
Besides
the
high
incidence
of
AKI
in
critically
ill-children
admitted
to
the
PICU
(
25
.
1
%
)
,
the
condition
was
associated
with
adverse
outcomes
,
including
high
mortality
(
46
.
3
%
)
and
need
for
dialysis
(
27
.
8
%
)
.
Infections
dominated
the
etiological
profile
.
Requirement
of
mechanical
ventilation
predicted
an
adverse
outcome
in
our
patient
population
.
Diseases
Validation
Diseases presenting
"pneumonia"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
allergic bronchopulmonary aspergillosis
alpha-thalassemia
classical phenylketonuria
cohen syndrome
congenital diaphragmatic hernia
heparin-induced thrombocytopenia
hydrocephalus with stenosis of the aqueduct of sylvius
junctional epidermolysis bullosa
lamellar ichthyosis
legionellosis
liposarcoma
lymphangioleiomyomatosis
monosomy 21
oculocutaneous albinism
omenn syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
scrub typhus
severe combined immunodeficiency
triple a syndrome
waldenström macroglobulinemia
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated