Acute kidney injury in children and adolescents admitted for pneumonia in the Philippines.

Abstract

Background: Acute kidney injury (AKI) in children increases the risk of adverse outcomes, and its incidence is higher in low- and middle-income countries-with infectious and diarrheal diseases greatly contributing to its development. The incidence of AKI in patients with pneumonia is poorly described in the literature. This study determined the clinical profile of AKI among children with pneumonia at the emergency department in a university hospital in the Philippines.

Methods: Records of 306 patients aged 1 month to 18 years with pneumonia were retrospectively analyzed. The patients were divided into two groups based on the presence of AKI using the Kidney Disease Improving Global Outcomes creatinine-based criteria. Clinicodemographic, laboratory, and outcome parameters were compared between groups. Logistic regression analysis was performed to identify predictors of AKI.

Results: Prevalence of AKI was 19.28%. Moderate-severe dehydration [OR 2202.71, 95% CI 135.37, 35,841.88; p < 0.0001] and need for intubation [OR 25.04, 95% CI 6.7, 93.52; p < 0.0001] were the strongest predictors for AKI. Other identified predictors included: age 10 to < 19 years, preterm birth, severe wasting, overweight/obesity, and leukocytosis.

Conclusions: The burden of AKI in our population, especially stage 3 AKI, is substantial and leads to significant morbidity and mortality. There are multiple factors associated with its development among pediatric patients with pneumonia, and early identification and improved surveillance of those at risk are crucial in reducing the increased morbidity and mortality associated with its occurrence.