MON-281 CARDIORENAL SYNDROME-AN UNDERDIAGNOSED ENTITY IN CHILDREN

Abstract

To determine the etiology, incidence and outcome of cardiorenal syndrome(CRS). Its often a underdiagnosed in children Prospective descriptive study of children < 18 years of age who were admitted to our hospital between June 2017 and August 2018 with 1)primary renal dysfunction (CKD KDIGO stage 3-5D and AKI stage II and III as per pRIFLE criteria) and developed secondary cardiac dysfunction (abnormal echocardiogram including low left ventricular ejection fraction, regional wall motion abnormalities, cardiogenic shock) or 2) primary cardiac disease (congenital or acquiredheart disease) and developed secondary renal dysfunction(AKI stages I-III with or without proteinuria).Baseline characteristics including age, sex, etiology, blood pressure, number of hospitalization were taken. Patients were classified into 5 types of CRS using the 7th acute dialysis quality initiative (ADQI) workgroup classification Total of78 children were included for analysis. who met the inclusion criteria, among those 9%,1%,33%,42% and 15% had CRS type 1,2,3,4 and 5, respectively. Cardiac disease leading to CRS were myocarditis(42%), dilated cardiomyopathy(42%) followed by rheumatic heart disease(14%); renal disease associated with CRS were chronic kidney disease(66%) followed by acute kidney injury(44%) and systemic disorder leading to CRS were severe sepsis(41%), MODS(25%), severe dengue(25%) and CMV infection(8%). The incidence of CRS is quite high in children with cardiac, renal and systemic diseases; risk factors of acute renal failure are multiple. Children presenting with these illnesses should be monitored for the occurrence of CRS so that early intervention may reduce mortality and morbidity.