28-Day Mortality Risk Increases for Children With Severe AKI

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Increased use of mechanical ventilation, renal-replacement therapy in children with severe AKI
Increased use of mechanical ventilation, renal-replacement therapy in children with severe AKI

HealthDay News — Acute kidney injury is associated with increased risk of 28-day mortality among critically ill children and young adults, according to a study published online November 18 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Society of Nephrology (Kidney Week), held from November 15 to 20 in Chicago.

Ahmad Kaddourah, MD, from the Cincinnati Children's Hospital, and colleagues conducted a prospective study involving patients admitted to pediatric intensive care units with severe acute kidney injury, defined using the Kidney Disease: Improving Global Outcomes criteria. A total of 4,683 patients aged 3 months to 25 years of age were screened during three consecutive months. 

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The researchers found that acute kidney injury developed in 1,261 patients (26.9%) and severe acute kidney injury developed in 543 patients (11.6%). After adjustment for 16 covariates, severe acute kidney injury conferred an increased risk of death by day 28 (adjusted odds ratio, 1.77); death occurred in 11.0% of patients with severe acute kidney injury versus 2.5% in those without severe acute kidney injury (P<0.001). There was an increase in use of mechanical ventilation and renal-replacement therapy in association with severe acute kidney injury, and a stepwise increase in 28-day mortality with worsening severity of acute kidney injury (P<0.001).

"Acute kidney injury is common and is associated with poor outcomes, including increased mortality, among critically ill children and young adults," the authors write.

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