English

Abstract

OBJECTIVES: To determine the incidence, age & sex ratio, analyse the spectrum of Acute Kidney Injury (AKI) in its aetiopathology, complications including mortality, prognostic factors and the role of dialysis in the management. METHODS: This prospective observational study was conducted on serial cases of 30 patients admitted in Paediatrics department from Feb 2012-Aug 2014 (30 months). RESULTS: The incidence of AKI was 0.44%. Children in age group of 0-4 yrs were affected most, predominantly males. Distribution of AKI according to aetiopathogenesis was Acute Tubular Necrosis (ATN) 50%, Haemolytic Uraemic Syndrome (HUS) 19.8%, Glomerulonephritis (GN) 13.2%, Obstructive uropathy 9.9% and Acute on Chronic renal failure (CRF) 6.6%. Dialysis was required in 53.3% of patients. Mortality was 57%. Patients with complications of sepsis, neurological & respiratory problems, hyperkalemia, metabolic acidosis and gastrointestinal bleeding were associated with high mortality. CONCLUSIONS: AKI is a common life threatening condition seen in childhood. Early referral, proper assessment, adequate INTRODUCTION: Acute renal failure is a serious condition in children. (1) The term 'Acute Renal Failure' (ARF) was replaced by 'Acute Kidney Injury' (AKI) to provide uniform definition, classification and standardize patient care. (2) AKI is defined as abrupt (within 48hrs) reduction in kidney function, defined as an absolute increase in serum creatinine of >0.3mg/dl or reduction of urine output (oliguria of <0.5ml/kg/hr for more than 6 hrs). (2) Detection of the incidence, aetiological profile and outcome of AKI is important for commencement of preventive and therapeutic strategies. Few studies have been conducted to study AKI in children in the developing world in recent years. Considering the limited data available on paediatric AKI in India, the present study was undertaken.