Acute Kidney Injury in Iranian Children -What Do We Know About It? - Part 2

Abstract

Acute kidney injury (AKI) is reversible deterioration of renal function in which waste products accumulate and fluid imbalance occurs. The epidemiology of AKI has been changing over years. The aim of this study was to evaluate the epidemiology of AKI in hospitalized children in Iran. A literature search from March 2000 to March 2014 was conducted through MEDLINE, EMBASE, Scholar.google, IranMedex, MagIran, SID, and manual reference search of identified articles. Retrospective and prospective cross-sectional studies with a clear definition of acute kidney injury or failure were included. Seven out of twenty three articles which were found met the criteria. The incidence of AKI declined from 36% (2006-2008) to 15.4% (2010-2011) in the PICU setting of three referral teaching hospitals in Tehran. According to the classification, 10% had pre-renal failure, 86% had intrinsic renal failure, and 4% had post-obstructive uropathy. Follow-up was limited to the days of hospitalization. The overall reported mortality rate was 18% in pediatric departments. Acute glomerulonephritis including hemolytic uremic syndrome was the most common underlying disease (46.5%). Acute tubular necrosis was reported in 33% of the cases. One third of the cases of acute renal failure occurred in children less than two years. The real incidence of acute kidney injury might be higher considering a unified standard definition. Acute glomerulonephritis and acute tubular necrosis comprised the majority of the etiologies. Keywords: Acute Kidney Injury; Middle East; Iran; Etiology; Child; Incidence; Review Systematic.