Clinical analysis of prognostic factors in 118 children with acute kidney injury / 中华肾脏病杂志

ABSTRACT

Objective To explore the risk factors of prognosis for children with acute kidney injury (AKI). Methods Clinical data of 118 children with AKI, including the causes,clinical characteristics, laboratory features, renal pathological findings, treatment and outcome, were reviewed retrospectively. Association between risk factors and prognosis was analyzed. AKI was defined by the new classification criteria of the Acute Kidney Injury Network. Prognostic factors were determined by univariate methods and stepwise multiple logistic regression analysis. Results One hundred and eighteen patients (83 male, 35 female) were enrolled in the study, who admitted in our department between January 1, 2005 and May 31, 2008. Median age at the time of AKI children was 7.5 years (range 1 day-14 years), among whom 28.0% (33 cases) was less than 3.0years, 17.8% (21 cases) between 3.0 and 7.0 years and 54.2% (64 cases) more than 7.0 years.Patients' AKI was classified according to the staging system as follows 52.5% stage 1, 32.2%stage 2 and 15.3% stage 3. The common causes of AKI children were infectious and autoimmune diseases (39.8%), renal vascular disease (27.1%) and circulatory disturbance (11.9%). Hospital mortality was 21.2%. Multivariate analysis showed that independent risk factors for death were need for mechanical ventilation (OR=51.75, P＜0.01＝, sepsis/septic shock (OR=14.76, P＜0.01＝, severe acidosis (OR=11.38, P＜0,01＝, and white blood cells (WBC) count more than 20.0×109/L (OR=8.51, P＜0.01＝. Conclusion Infectious and autoimmune diseases, renal vascular disease and circulatory disturbance are the common causes of AKI children. The important risk factors of death in AKI children are need for mechanical ventilation, sepsis/septic shock, severe acidosis, and WBC count more than 20.0×109/L.