Acute kidney injury in children hospitalized for acute gastroenteritis: prevalence and risk factors

Autor:	Maria Baldascino, Felice Nunziata, Emanuele Miraglia del Giudice, Pierluigi Marzuillo, Silverio Perrotta, Stefano Guarino
Přispěvatelé:	Marzuillo, Pierluigi, Baldascino, Maria, Guarino, Stefano, Perrotta, Silverio, Miraglia Del Giudice, Emanuele, Nunziata, Felice
Rok vydání:	2021
Předmět:	Diarrhea Nephrology medicine.medical_specialty Vomiting medicine.medical_treatment urologic and male genital diseases Logistic regression chemistry.chemical_compound Internal medicine medicine Children Creatinine Acute gastroenteriti urogenital system business.industry Acute kidney injury medicine.disease female genital diseases and pregnancy complications Acidosi chemistry Pediatrics Perinatology and Child Health Risk factor Hemodialysis medicine.symptom business Kidney disease
Zdroj:	Pediatric Nephrology. 36:1627-1635
ISSN:	1432-198X 0931-041X
DOI:	10.1007/s00467-020-04834-7
Popis:	Background We aimed to evaluate prevalence of acute kidney injury (AKI) and its risk factors in children hospitalized for acute gastroenteritis (AGE) to identify early predictors of AKI. Methods We retrospectively collected clinical and biochemical data of 114 children (57.9% male; mean age 2.9 ± 2.8 years) hospitalized for AGE. AKI was defined according to Kidney Disease/Improving Global Outcomes creatinine criteria. We considered basal serum creatinine as value of creatinine estimated with Hoste (age) equation assuming basal eGFRs were median age-based eGFR normative values for children ≤ 2 years of age, and eGFR 120 mL/min/1.73m2 for children > 2 years. Univariate and multivariate logistic regression models were used to explore associations with AKI. We included in multivariate analyses only variables with significant p after Bonferroni correction. Results AKI was found in 28/114 (24.6%) patients. No patients required hemodialysis, 2 (1.8%) reached AKI stage 3, 2 (1.8%) AKI stage 2, and 24 (21.0%) AKI stage 1. Mean length of stay was 3.6 ± 1.2, 5.0 ± 1.8, and 10.5 ± 5.8 days, for patients with no, mild, and severe AKI (p < 0.001), respectively. Duration of symptoms before hospitalization (OR = 2.5; 95% CI = 1.3–5.0; p = 0.006), dehydration > 5% (OR = 43.1; 95% CI = 5.4–344.1; p = < 0.001), and serum bicarbonate levels (OR = 1.6; 95% CI = 1.2–2.1; p = 0.001) were independent predictors of AKI. Conclusions About one quarter of patients hospitalized for AGE may suffer from AKI with a longer stay for patients with more severe AKI. Particular attention, however, should be paid to volemia and kidney health of patients with AGE especially in the presence of increased duration of symptoms before hospitalization, dehydration, and lower serum bicarbonate levels. Graphical abstract
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5d8a87d26bb9b1411b4c641c3d7cd4fe https://doi.org/10.1007/s00467-020-04834-7 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.