儿童急性肾损伤的流行病学和结局——来自中低收入国家的多中心观察性研究。

IF 2.6 3区 医学 Q1 PEDIATRICS
Pediatric Nephrology Pub Date : 2025-11-01 Epub Date: 2025-07-01 DOI:10.1007/s00467-025-06856-5
Uma Ali, Amol Madave, Kinnari Vala, Sadhana Zope, Manoj Matnani, Jyoti Singhal, Anupama Mauskar, Poonam Wade, Radha Ghildiyal, Jyoti Sharma, Madhulika Chakravarthi, Puneet Chhajed, Nivedita Pande, Nisha Krishnamurthy, Aarthi Prasanna, Kiran Sathe, Atul Deokar, Manish Arya, Vaibhav Keskar, Pawan Deore
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引用次数: 0

摘要

背景:中低收入国家(LMICs)的急性肾损伤(AKI)的流行病学和结果与高收入国家不同,这是由于非肾脏系统疾病的类型和严重程度以及肾脏学护理设施的差异。来自中低收入国家的多中心研究很少。本多中心观察性研究旨在研究LMIC儿童AKI的流行病学,并分析相关样本特征和干预措施对结局(即肾脏恢复和死亡率)的意义。方法:根据KDIGO标准诊断为AKI的儿童(1个月-18岁),来自10个中心,时间超过30个月。收集的数据包括医院类型、城市、患者人口统计、疾病特征、既往疾病、AKI概况、包括机械通气(MV)、血管活性药物(VADs)、肾毒性药物、造影剂暴露和近期手术在内的干预措施。评估肾脏替代疗法(KRT)的使用、方式、肾脏恢复和患者生存。结果:非肾脏全身性疾病占79%。大多数是感染。55%的人患有既往疾病,29%的人患有肾脏疾病。入院时诊断为AKI的比例为68%,其中40%为KDIGO 3期;50%患有严重急性肾损伤。MV和vad分别占42%和46%。29%需要KRT,大多数接受急性腹膜透析(58%)。44%的患者完全康复,29.6%的患者死亡。先前存在的肾脏疾病和KRT对CR有负面影响。VAD的使用与死亡率相关,而CR与生存率相关。结论:非肾脏全身性感染是AKI的主要原因,其特点是进展早、迅速,50%为重症,KRT需要率高,CR低于50%,死亡率高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology and outcome of pediatric acute kidney injury-multicenter observational study from a low-middle-income country.

Background: The epidemiology and outcome of acute kidney injury (AKI) in low-middle-income countries (LMICs) differ from those in high-income countries due to differences in type and severity of non-renal systemic illness and variability in nephrology-care facilities. There is a paucity of multicenter studies from LMICs. This multicenter observational study was undertaken to study the epidemiology of pediatric AKI in a LMIC and analyze the significance of associated sample characteristics and interventions on outcomes, namely renal recovery and mortality.

Methods: Children (1 month-18 years) diagnosed with AKI, based on KDIGO criteria, seen in 10 centers, over 30 months, were included. Data collected included hospital type, city, patient demographics, illness characteristics, pre-existing diseases, AKI profile, interventions including mechanical ventilation (MV), vasoactive drugs (VADs), nephrotoxic drugs, radiocontrast exposure, and recent surgery. Use of kidney replacement therapy (KRT), modality, renal recovery, and patient survival was assessed.

Results: Non-renal systemic illness accounted for 79% of cases. Majority were infections. Pre-existing illness was present in 55%, with 29% having kidney disease. AKI was diagnosed at admission in 68%, with 40% in KDIGO stage 3; 50% had severe AKI. MV and VADs were used in 42% and 46%, respectively. KRT was required in 29%, most receiving acute peritoneal dialysis (58%). Complete recovery (CR) was seen in 44%, while 29.6% died. Pre-existing kidney disease and KRT negatively impacted CR. VAD use was linked to mortality, and CR was associated with survival.

Conclusions: Non-renal systemic infection was the leading cause of AKI characterized by early, rapid progression, severe in 50%, high need for KRT, CR in less than 50% and high mortality.

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来源期刊
Pediatric Nephrology
Pediatric Nephrology 医学-泌尿学与肾脏学
CiteScore
4.70
自引率
20.00%
发文量
465
审稿时长
1 months
期刊介绍: International Pediatric Nephrology Association Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.
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