Ten-year follow-up of children after acute renal failure from a developing country

Sinha, Rajiv; Nandi, Madhumita; Tullus, Kjell; Marks, Stephen D.; Taraphder, Abhijit

doi:10.1093/ndt/gfn539

Cited by 49 publications

(32 citation statements)

References 13 publications

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“…Recent reviews detail the high rates of CKD, hypertension, and microalbuminuria in children who survive an AKI episode (50 ) and reveal a very low rate of long-term follow-up. Children who develop AKI do, in fact, display long-term findings of CKD, as evidenced by the development of hypertension, microalbuminuria, and reduced GFR (Table 2) (37,(51)(52)(53)(54)(55)(56). The post-AKI rates of hypertension, microalbuminuria, and low GFR are remarkable, given the low prevalence of these kidney-related outcomes in the general pediatric population.…”

Section: Aki To Ckd In Childrenmentioning

confidence: 99%

AKI Transition of Care

Goldstein

Jaber

Faubel

et al. 2013

Clinical Journal of the American Society of Nephrology

180

124

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SummaryThe incidence rate of AKI is increasing across the spectrum of hospitalized children and adults. Given the increased morbidity and mortality associated with AKI, significant research effort has been appropriately focused on standardizing AKI definitions, identifying risk factors, and discovering and validating novel, earlier structural biomarkers of kidney injury. In addition, a growing body of evidence demonstrates that AKI is a risk factor for the future development or accelerated progression of CKD. Unfortunately, prospective observational studies have not consistently followed survivors of episodes of AKI for longitudinal outcomes after hospital discharge, which could lead to ascertainment bias in terms of over-or underestimation of CKD development. Furthermore, data show that clinical follow-up of AKI survivors is low. This lack of systematic study and clinical follow-up represents a potential missed opportunity to prevent chronic disease after an acute illness and improve outcomes. Therefore, prospective study of transitions of care after episodes of AKI is needed to identify which patients are at risk for CKD development and to optimally target therapeutic interventions.

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Section: Aki To Ckd In Childrenmentioning

confidence: 99%

AKI Transition of Care

Goldstein

Jaber

Faubel

et al. 2013

Clinical Journal of the American Society of Nephrology

180

124

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“…The investigators found that acute mortality was significantly associated with peak creatinine and the presence of multiple organ failure. Of the survivors, 25% had renal morbidity after 10 years, with at least one of four abnormal renal parameters, including abnormal creatinine, hypertension, hematuria, and proteinuria [63]. Beyond these few studies, there is not much literature on long-term outcome in pediatric AKI.…”

Section: Long-term Prognosismentioning

confidence: 99%

Acute kidney injury: can we improve prognosis?

Hsu

Symons

2010

Pediatr Nephrol

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The incidence of pediatric acute kidney injury (AKI) is increasing. AKI has been found to be independently associated with increased mortality, and current management options are limited in that they are mainly supportive. The use of various definitions of AKI can still be found in the literature, making it difficult to discern the epidemiology behind pediatric AKI. The use of a more uniform definition is a necessary first step to clarify AKI epidemiology and direct our research efforts, and it will ultimately improve prognosis. There is evidence that neonates and infants may be at higher risk for AKI than adults. However, the least amount of research is found for this youngest age group, and more focused efforts on this population are necessary. This paper reviews existing data on and definitions for pediatric AKI, general preventive and treatment strategies, as well as ongoing research efforts on AKI. We are hopeful that the prognosis of AKI will improve with collaboration on a multicenter, multinational scale in the form of prospective, long-term studies on pediatric AKI.

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“…Children with AKI experience longer hospitalizations, prolonged intensive care unit (ICU) stays, and greater need for mechanical ventilation (6,9). Additionally, children who survive AKI are likely to experience residual renal abnormalities; proteinuria, hypertension, and reduced GFRs persist in up to 60% of AKI survivors (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

AKI in Hospitalized Children

Sutherland

Ji²,

Sheikhi³

et al. 2013

Clinical Journal of the American Society of Nephrology

223

154

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SummaryBackground and objectives Although AKI is common among hospitalized children, comprehensive epidemiologic data are lacking. This study characterizes pediatric AKI across the United States and identifies AKI risk factors using high-content/high-throughput analytic techniques.Design, setting, participants, & measurements For the cross-sectional analysis of the 2009 Kids Inpatient Database, AKI events were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Demographics, incident rates, and outcome data were analyzed and reported for the entire AKI cohort as well as AKI subsets. Statistical learning methods were applied to the highly imbalanced dataset to derive AKI-related risk factors.Results Of 2,644,263 children, 10,322 children developed AKI (3.9/1000 admissions). Although 19% of the AKI cohort was #1 month old, the highest incidence was seen in children 15-18 years old (6.6/1000 admissions); 49% of the AKI cohort was white, but AKI incidence was higher among African Americans (4.5 versus 3.8/1000 admissions). In-hospital mortality among patients with AKI was 15.3% but higher among children #1 month old (31.3% versus 10.1%, P,0.001) and children requiring critical care (32.8% versus 9.4%, P,0.001) or dialysis (27.1% versus 14.2%, P,0.001). Shock (odds ratio, 2.15; 95% confidence interval, 1.95 to 2.36), septicemia (odds ratio, 1.37; 95% confidence interval, 1.32 to 1.43), intubation/mechanical ventilation (odds ratio, 1.2; 95% confidence interval, 1.16 to 1.25), circulatory disease (odds ratio, 1.47; 95% confidence interval, 1.32 to 1.65), cardiac congenital anomalies (odds ratio, 1.2; 95% confidence interval, 1.13 to 1.23), and extracorporeal support (odds ratio, 2.58; 95% confidence interval, 2.04 to 3.26) were associated with AKI.Conclusions AKI occurs in 3.9/1000 at-risk US pediatric hospitalizations. Mortality is highest among neonates and children requiring critical care or dialysis. Identified risk factors suggest that AKI occurs in association with systemic/multiorgan disease more commonly than primary renal disease.

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Ten-year follow-up of children after acute renal failure from a developing country

Abstract: We found that nearly 25% (n = 6) of the survivors of an acute episode of renal failure had renal morbidity after 10 years, a percentage significant enough for these children to need long-term follow-up.

Cited by 49 publications

References 13 publications

AKI Transition of Care

AKI Transition of Care

Acute kidney injury: can we improve prognosis?

AKI in Hospitalized Children

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