Acute Renal Failure in the Pediatric Intensive Care Unit: Incidence and Its Effects on Clinical Outcomes

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2024-07-07 DOI:10.5812/ijp-143669

Zahra Pournasiri, Seyedeh Masumeh Hashemi, Seyedeh Narjes Ahmadizadeh, Azita Behzad, N. Esfandiar, Ali Hakimhashemi

{"title":"Acute Renal Failure in the Pediatric Intensive Care Unit: Incidence and Its Effects on Clinical Outcomes","authors":"Zahra Pournasiri, Seyedeh Masumeh Hashemi, Seyedeh Narjes Ahmadizadeh, Azita Behzad, N. Esfandiar, Ali Hakimhashemi","doi":"10.5812/ijp-143669","DOIUrl":null,"url":null,"abstract":"Background: Renal dysfunction is a prevalent complication among patients admitted to intensive care units (ICUs), significantly impacting patient outcomes. Objectives: This study focuses on assessing the incidence of acute renal failure (ARF) in pediatric patients hospitalized in ICUs, exploring its occurrence and associated effects on patient outcomes. Methods: A prospective observational study was conducted to examine the incidence of ARF in pediatric patients admitted to a tertiary pediatric hospital's intensive care unit (PICU) in Iran from September 2019 to August 2020. Patients who developed ARF during their ICU stay were included in the study. Clinical and laboratory data were systematically collected upon admission and on a daily basis thereafter. This data collection aimed to elucidate differences in etiology, disease severity, and clinical practices, and to ascertain their impact on patient outcomes. Results: Out of 1145 pediatric ICU admissions, 4.3% experienced acute renal failure during their hospitalization. Of the 49 affected patients, information was available for 46 individuals, constituting the final analysis cohort. The staging of renal failure was categorized as follows: Stage I (45.7%), Stage II (19.6%), and Stage III (34.8%). Acute tubular necrosis emerged as the predominant cause of acute kidney injury (60.8%). The mortality rate among these patients was notably high at 39.1%, compared to the general PICU mortality rate of 7.1% during the study period. Non-survivors exhibited a higher prevalence of antibiotic use, particularly aminoglycosides and antifungal drugs. Additionally, resuscitation procedures were more frequently documented among non-survivors. Conclusions: Approximately 4.3% of pediatric ICU patients develop acute renal failure, with half of the cases manifesting within the initial 24 hours of hospitalization. Acute tubular necrosis stands out as the primary cause of acute kidney injury. A substantial proportion of patients (39.1%) succumb to the condition, particularly those subjected to resuscitation efforts or prescribed multiple antibiotics and antifungal drugs during hospitalization.","PeriodicalId":14593,"journal":{"name":"Iranian Journal of Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5812/ijp-143669","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Renal dysfunction is a prevalent complication among patients admitted to intensive care units (ICUs), significantly impacting patient outcomes. Objectives: This study focuses on assessing the incidence of acute renal failure (ARF) in pediatric patients hospitalized in ICUs, exploring its occurrence and associated effects on patient outcomes. Methods: A prospective observational study was conducted to examine the incidence of ARF in pediatric patients admitted to a tertiary pediatric hospital's intensive care unit (PICU) in Iran from September 2019 to August 2020. Patients who developed ARF during their ICU stay were included in the study. Clinical and laboratory data were systematically collected upon admission and on a daily basis thereafter. This data collection aimed to elucidate differences in etiology, disease severity, and clinical practices, and to ascertain their impact on patient outcomes. Results: Out of 1145 pediatric ICU admissions, 4.3% experienced acute renal failure during their hospitalization. Of the 49 affected patients, information was available for 46 individuals, constituting the final analysis cohort. The staging of renal failure was categorized as follows: Stage I (45.7%), Stage II (19.6%), and Stage III (34.8%). Acute tubular necrosis emerged as the predominant cause of acute kidney injury (60.8%). The mortality rate among these patients was notably high at 39.1%, compared to the general PICU mortality rate of 7.1% during the study period. Non-survivors exhibited a higher prevalence of antibiotic use, particularly aminoglycosides and antifungal drugs. Additionally, resuscitation procedures were more frequently documented among non-survivors. Conclusions: Approximately 4.3% of pediatric ICU patients develop acute renal failure, with half of the cases manifesting within the initial 24 hours of hospitalization. Acute tubular necrosis stands out as the primary cause of acute kidney injury. A substantial proportion of patients (39.1%) succumb to the condition, particularly those subjected to resuscitation efforts or prescribed multiple antibiotics and antifungal drugs during hospitalization.

查看原文本刊更多论文

儿科重症监护室中的急性肾衰竭：发病率及其对临床结果的影响

背景：肾功能障碍是重症监护病房（ICU）收治的患者中普遍存在的并发症，严重影响患者的预后。研究目的本研究的重点是评估在重症监护病房住院的儿科患者中急性肾功能衰竭（ARF）的发生率，探讨其发生率及其对患者预后的相关影响。研究方法研究人员开展了一项前瞻性观察研究，调查了2019年9月至2020年8月期间伊朗一家三级儿科医院重症监护室（PICU）收治的儿科患者中ARF的发生率。研究纳入了在重症监护病房住院期间出现 ARF 的患者。研究人员在患者入院时系统地收集了临床和实验室数据，并在此后每天收集这些数据。收集数据的目的是阐明病因、疾病严重程度和临床实践的差异，并确定它们对患者预后的影响。结果在重症监护病房收治的 1145 名儿科患者中，4.3% 的患者在住院期间出现急性肾功能衰竭。在 49 名受影响的患者中，有 46 人的信息可用，他们构成了最终的分析队列。肾衰竭的分期情况如下：I期（45.7%）、II期（19.6%）和III期（34.8%）。急性肾小管坏死是急性肾损伤的主要原因（60.8%）。在研究期间，这些患者的死亡率高达 39.1%，而 PICU 的总死亡率为 7.1%。非幸存者使用抗生素的比例较高，尤其是氨基糖苷类和抗真菌药物。此外，非存活者的复苏程序记录更频繁。结论约有 4.3% 的儿科重症监护病房患者会出现急性肾功能衰竭，其中半数病例在住院最初的 24 小时内出现。急性肾小管坏死是急性肾损伤的主要原因。相当一部分患者（39.1%）会因此而死亡，尤其是那些在住院期间接受抢救或服用多种抗生素和抗真菌药物的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.