Tareq Alayed, Abdulaziz Alansary, Mohammed Al-Nahdi, Abdullah Alotaibi, Raghad Alhuthil, Moath Al Abdulsalam, Fahad Aljofan, Abdullah Alturki, Tariq Alofisan
{"title":"危重儿童急性肾损伤的发生率、结局和死亡率危险因素：沙特阿拉伯三级保健中心研究","authors":"Tareq Alayed, Abdulaziz Alansary, Mohammed Al-Nahdi, Abdullah Alotaibi, Raghad Alhuthil, Moath Al Abdulsalam, Fahad Aljofan, Abdullah Alturki, Tariq Alofisan","doi":"10.5144/0256-4947.2025.62","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate.</p><p><strong>Objectives: </strong>Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>A PICU.</p><p><strong>Patients and methods: </strong>The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre.</p><p><strong>Main outcomes measures: </strong>AKI incidence, outcomes, and mortality-related risk factors.</p><p><strong>Sample size: </strong>111 records of patients with AKI.</p><p><strong>Results: </strong>Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16-120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (<i>P</i>=.042) and inotropic support (<i>P</i>=.001) as significant predictors of mortality.</p><p><strong>Conclusion: </strong>These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted.</p><p><strong>Limitations: </strong>Retrospective study single-center nature.</p>","PeriodicalId":93875,"journal":{"name":"Annals of Saudi medicine","volume":"45 1","pages":"62-68"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810873/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia.\",\"authors\":\"Tareq Alayed, Abdulaziz Alansary, Mohammed Al-Nahdi, Abdullah Alotaibi, Raghad Alhuthil, Moath Al Abdulsalam, Fahad Aljofan, Abdullah Alturki, Tariq Alofisan\",\"doi\":\"10.5144/0256-4947.2025.62\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate.</p><p><strong>Objectives: </strong>Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>A PICU.</p><p><strong>Patients and methods: </strong>The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre.</p><p><strong>Main outcomes measures: </strong>AKI incidence, outcomes, and mortality-related risk factors.</p><p><strong>Sample size: </strong>111 records of patients with AKI.</p><p><strong>Results: </strong>Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16-120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (<i>P</i>=.042) and inotropic support (<i>P</i>=.001) as significant predictors of mortality.</p><p><strong>Conclusion: </strong>These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted.</p><p><strong>Limitations: </strong>Retrospective study single-center nature.</p>\",\"PeriodicalId\":93875,\"journal\":{\"name\":\"Annals of Saudi medicine\",\"volume\":\"45 1\",\"pages\":\"62-68\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810873/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Saudi medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2025.62\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5144/0256-4947.2025.62","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/6 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Incidence, outcomes, and mortality risk factors of acute kidney injury in critically ill children: a tertiary care center study in Saudi Arabia.
Background: Acute kidney injury (AKI) is a critical concern in pediatric intensive care units (PICUs) due to its high mortality rate.
Objectives: Investigate AKI incidence, outcomes, and mortality-related risk factors among critically ill children.
Design: Retrospective cohort.
Setting: A PICU.
Patients and methods: The study included children (aged 4 weeks to 14 years) who were admitted to the PICU from (2016 to 2019) and developed AKI at King Faisal Specialist Hopsital and Research Centre.
Main outcomes measures: AKI incidence, outcomes, and mortality-related risk factors.
Sample size: 111 records of patients with AKI.
Results: Of 969 PICU admissions, 111 cases developed AKI and were entered in the analysis, with an incidence rate of (11.5%). The median age was 43 months [interquartile range (IQR): 16-120], with hematology/oncology conditions being the most prevalent underlying diseases (56.8%). Septic shock and nephrotoxin medications were the leading causes of AKI, accounting for (46.8%) and (45.0%), respectively. Regarding AKI severity, (37.8%) were classified as stage 1, (25.2%) as stage 2, and (37.0%) as stage 3 AKI. As for PICU interventions, the highest was inotropic support (63.1%), followed by mechanical ventilation (56.8%) and renal replacement therapy (23.4%). The PICU mortality rate was (38.7%) (43/111), with no significant association between AKI stage and mortality. However, the multivariable analysis identified bone marrow transplant (BMT) (P=.042) and inotropic support (P=.001) as significant predictors of mortality.
Conclusion: These findings underscore the importance of early recognition and tailored management of AKI in PICU settings. Despite advancements in critical care, AKI remains a significant challenge, contributing to prolonged hospitalization, mortality, and increased health-care resource utilization. Therefore, more investigation is warranted.
Limitations: Retrospective study single-center nature.
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