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Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study.
Pediatr Crit Care Med. 2007 Jan; 8(1):29-35.PC

Abstract

OBJECTIVE

Acute renal failure is a serious condition in critically ill patients, but little literature is available on acute renal failure in critically ill children. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of acute renal failure in the pediatric intensive care unit (PICU).

DESIGN

Prospective, descriptive study.

SETTING

A tertiary PICU.

PATIENTS

Patients were 1,047 consecutively admitted children over a 1-yr period.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Acute renal failure was defined as doubling of baseline serum creatinine. A comparison between patients with acute renal failure and without acute renal failure was carried out, and the risk factors playing a significant role in the manifestation of acute renal failure were analyzed. There were 985 cases included in the study, with the incidence rate of acute renal failure in PICU being 4.5%. The most common PICU admission diagnoses in acute renal failure cases were hemolytic uremic syndrome (18.2%), oncologic pathologies (18.2%), and cardiac surgery (11.4%). Significant risk factors for acute renal failure following multivariate analysis were thrombocytopenia (odds ratio, 6.3; 95% confidence interval, 2.5, 16.2), age >12 yrs (odds ratio, 4.9; 95% confidence interval, 1.9, 13), hypoxemia (odds ratio, 3.2; 95% confidence interval, 1.3, 8.0), hypotension (odds ratio, 3.0; 95% confidence interval, 1.2, 7.5), and coagulopathy (odds ratio, 2.7; 95% confidence interval, 1.3, 5.6). The mortality rate was estimated to be higher in patients with acute renal failure compared with patients without acute renal failure (29.6% vs. 2.3%, p < .001).

CONCLUSIONS

Although not frequent in the PICU, acute renal failure is associated with a significant increase in mortality. The risk factors of acute renal failure are multiple and are often present before PICU admission. A multiple-center study is planned with the intention to confirm these results.

Authors+Show Affiliations

Service of Pediatric Critical Care Medicine, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montréal, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17251879

Citation

Bailey, Dennis, et al. "Risk Factors of Acute Renal Failure in Critically Ill Children: a Prospective Descriptive Epidemiological Study." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 8, no. 1, 2007, pp. 29-35.
Bailey D, Phan V, Litalien C, et al. Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study. Pediatr Crit Care Med. 2007;8(1):29-35.
Bailey, D., Phan, V., Litalien, C., Ducruet, T., Mérouani, A., Lacroix, J., & Gauvin, F. (2007). Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 8(1), 29-35.
Bailey D, et al. Risk Factors of Acute Renal Failure in Critically Ill Children: a Prospective Descriptive Epidemiological Study. Pediatr Crit Care Med. 2007;8(1):29-35. PubMed PMID: 17251879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study. AU - Bailey,Dennis, AU - Phan,Véronique, AU - Litalien,Catherine, AU - Ducruet,Thierry, AU - Mérouani,Aicha, AU - Lacroix,Jacques, AU - Gauvin,France, PY - 2007/1/26/pubmed PY - 2007/4/14/medline PY - 2007/1/26/entrez SP - 29 EP - 35 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 8 IS - 1 N2 - OBJECTIVE: Acute renal failure is a serious condition in critically ill patients, but little literature is available on acute renal failure in critically ill children. The aim of the study was to determine incidence rate, identify risk factors, and describe the clinical outcome of acute renal failure in the pediatric intensive care unit (PICU). DESIGN: Prospective, descriptive study. SETTING: A tertiary PICU. PATIENTS: Patients were 1,047 consecutively admitted children over a 1-yr period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Acute renal failure was defined as doubling of baseline serum creatinine. A comparison between patients with acute renal failure and without acute renal failure was carried out, and the risk factors playing a significant role in the manifestation of acute renal failure were analyzed. There were 985 cases included in the study, with the incidence rate of acute renal failure in PICU being 4.5%. The most common PICU admission diagnoses in acute renal failure cases were hemolytic uremic syndrome (18.2%), oncologic pathologies (18.2%), and cardiac surgery (11.4%). Significant risk factors for acute renal failure following multivariate analysis were thrombocytopenia (odds ratio, 6.3; 95% confidence interval, 2.5, 16.2), age >12 yrs (odds ratio, 4.9; 95% confidence interval, 1.9, 13), hypoxemia (odds ratio, 3.2; 95% confidence interval, 1.3, 8.0), hypotension (odds ratio, 3.0; 95% confidence interval, 1.2, 7.5), and coagulopathy (odds ratio, 2.7; 95% confidence interval, 1.3, 5.6). The mortality rate was estimated to be higher in patients with acute renal failure compared with patients without acute renal failure (29.6% vs. 2.3%, p < .001). CONCLUSIONS: Although not frequent in the PICU, acute renal failure is associated with a significant increase in mortality. The risk factors of acute renal failure are multiple and are often present before PICU admission. A multiple-center study is planned with the intention to confirm these results. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/17251879/Risk_factors_of_acute_renal_failure_in_critically_ill_children:_A_prospective_descriptive_epidemiological_study_ L2 - https://doi.org/10.1097/01.pcc.0000256612.40265.67 DB - PRIME DP - Unbound Medicine ER -