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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
"common etiologies"
symptom
cushing syndrome
cystinuria
junctional epidermolysis bullosa
kallmann syndrome
kindler syndrome
primary effusion lymphoma
scrub typhus
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