Acute kidney injury applying pRifle scale in Children of Hospital Universitario del Valle in Cali, Colombia: clinical features, management and evolution
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Objective: to know the epidemiology of Acute Kidney Injury (AKI) in the pediatric population at Hospital Universitario del Valle (HUV), a tertiary University Hospital in Cali, Colombia.
Methods: We obtained a series of cases through daily surveillance for a seven-month period (June 1 to December 31, 2009) in patients older than 30 days and under 18 years at HUV. We excluded patients with previous diagnosis of chronic renal failure. The new pRIFLE scale was used to define AKI.
Results: 27 patients were detected, with mean age of 36 months. Incidence of AKI was 0.38% from pediatric admissions and 6.2% from the pediatric intensive care unit (pICU) admissions. The pRIFLE scale at study entrance was: Risk: 2 patients, Injury: 8, Failure: 17. Etiology of AKI was: pre-renal in 89%, primary renal disease in 3.7%, and post-renal in 7.4%. There was an association of AKI with sepsis in 66.7% and 48.2% progressed to septic shock. Six patients required renal replacement therapy, all required peritoneal dialysis. The AKI was multi-factorial in 59.3% and associated with systemic multi-organ failure in 59.3%. At study entry, 63% patients were in pICU. The average hospital stay was 21.3 ± 9.2 days. Six children died, 16 resolved AKI, and nine were left with renal sequelae.
Conclusions: We recommended pRIFLE scale for early diagnosis of AKI in all pediatric services. Education in pRIFLE scale, prevention of AKI, and early management of sepsis and hypovolemia is recommended.
- Acute Kidney Injury
- Classification
- pRIFLE
- Etiology
- Sepsis
- Children.
Phan V, Brophy P, Fleming G. Acute renal Failure: prevention, causes, and investigation. In: Geary D, Schaefer F (eds). Comprehensive pediatric nephrology. Philadelphia: Mosby, Elsevier; 2008.p 607-27. DOI: https://doi.org/10.1016/B978-0-323-04883-5.50045-3
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group. Crit Care Med. 2004; 8: 204–12.
Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jeffer¬son LS, Goldstein S. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int. 2007; 71:1028–35. DOI: https://doi.org/10.1038/sj.ki.5002231
Mak RH. Acute kidney injury in children: the dawn of a new era. Pediatr Nephrol. 2008; 23: 2147–9. DOI: https://doi.org/10.1007/s00467-008-1014-8
Hsu C W, Symons JM. Acute kidney injury: can we improve prognosis? Pediatr Nephrol. 2010; 25: 2401–12. DOI: https://doi.org/10.1007/s00467-010-1508-z
Duzova A, Bakkaloglu A, Kalyoncu M, Poyrazoglu H, Delibas A, Ozkaya O, et al., Etiology and outcome of acute kidney injury in children. Pediatr Nephrol. 2010; 25:1453-61. DOI: https://doi.org/10.1007/s00467-010-1541-y
Restrepo JM, Daza V, Villarreal N, Botero A, Leyes D, Bermú¬dez F, et al., Incidence of acute kidney injury in the pICU: Fun¬dación Valle del Lili Cali, Colombia 1996-2006. World Congress Nephrology WCN 2011 Satellite Symposium. 8th Conference on Kidney Disease in Disadvantaged Populations: Disparities in re¬nal disease - moving toward solutions; 2011; Victoria BC Canada. Abstracts p 70 # 161.
Restrepo JM, Castillo G, Casas A, Duque M, Ramirez O. One-year outcome of AKI using pRIFLE criteria in the pediatric inten¬sive care unit-pICU- at Fundación Valle del Lili (FVL) - Cali Co¬lombia (FVL) 2009-2010. World Congress of Nephrology WCN 2011 Sustainability and diversity; 2011; Vancouver Canada. Pro¬gram MO115 951.
Olowu W A, Adelusola KA. Pediatric acute renal failure in southwestern Nigeria. Kidney Int, 2004; 66: 1541–8. DOI: https://doi.org/10.1111/j.1523-1755.2004.00918.x
Palmieri T, Lavrentieva A, Greenhalgh D. An assessment of acute kidney injury with modified RIFLE criteria in pediatric pa¬tients with severe burns. IntensiveCareMed. 2009; 35:2125-9. DOI: https://doi.org/10.1007/s00134-009-1638-6
Schrier RW, Wang W. Acute renal failure and sepsis. N.Engl J Med 2004; 351:159-69 DOI: https://doi.org/10.1056/NEJMra032401
Chen Y Ch, Jenq Ch, Tian YC, Chang MY, Lin YC, Chang CH, et al., RIFLE classification for predicting in-hospital mortality in critically ill sepsis patients. Shock 2009; 31:139-45. DOI: https://doi.org/10.1097/SHK.0b013e31817d419e
Özcakar ZB, Yalcunkaya F, Atas B, Ergün H, Kendirli T, AteşC, et al., Application of a new classification criteria of Acute Kidney Injury Network: a pilot study in pediatric population. PediatrNe¬phrol 2009; 24: p 1379-84. DOI: https://doi.org/10.1007/s00467-009-1158-1
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- Adela Isabel Herrera, Consuelo de Rovetto, Iris de Castaño, Alexander Maximiliano Martínez, Alejandra Guerrero, Nutritional status in children with chronic renal failure in outpatient pediatric nephrology clinic at the Hospital Universitario del Valle, Cali , Colombia Medica: Vol. 40 No. 2 (2009)
- Iris de Castaño, Consuelo de Rovetto, Nutrition and renal disease. , Colombia Medica: Vol. 38 No. 1.Supl.1 (2007): Gastrología Pediátrica
- Iris de Castaño, Claudia González, Zaidy Yahaira Buitrago, Consuelo de Rovetto, Etiology and bacterial sensibility in children urinary infection. Hospital Infantil Club Noel and Hospital Universitario del Valle, Cali, Colombia. , Colombia Medica: Vol. 38 No. 2 (2007)
- Paula Hurtado, Harry Maurcio Pachajoa, Consuelo Restrepo de Rovetto, Letter to the Editor , Colombia Medica: Vol. 41 No. 2 (2010)
- Iris de Castaño, Principios y aplicaciones prácticas del estudio urodinámico en pediatría. , Colombia Medica: Vol. 36 No. 4.Supl.3 (2005)
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