The incidence of pediatric acute kidney injury is increased when identified by a change in a creatinine-based electronic alert
| Autor: | Gethin Roberts, Kay Tyerman, John D. Williams, John Geen, Aled O. Phillips, Kate May, Jennifer Holmes |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Adolescent 030232 urology & nephrology Renal function urologic and male genital diseases Pediatrics law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law 030225 pediatrics Internal medicine medicine Electronic Health Records Humans In patient Prospective Studies Stage (cooking) Intensive care medicine Child Creatinine Wales business.industry Incidence (epidemiology) Incidence Acute kidney injury Infant Newborn Infant Acute Kidney Injury medicine.disease R1 Intensive care unit female genital diseases and pregnancy complications chemistry Nephrology Child Preschool Female business Laboratory Critical Values Reporting system Biomarkers |
| Zdroj: | Kidney international. 92(2) |
| ISSN: | 1523-1755 0085-2538 |
| Popis: | A prospective national cohort study was undertaken to collect data on all cases of pediatric (under 18 yrs of age) acute kidney injury (AKI) identified by a biochemistry-based electronic alert using the Welsh National electronic AKI reporting system. Herein we describe the utility and limitation of using this modification of the KDIGO creatinine-based system data set to characterize pediatric AKI. Of 1,343 incident episodes over a 30-month period, 34.5% occurred in neonates of which 83.8% were AKI stage 1. Neonatal 30-day mortality was 4.1%, with 73.3% of this being accounted for by patients treated in an Intensive Care Unit. In the non-neonatal group, 76.1% were AKI stage 1. Hospital-acquired AKI accounted for 40.1% of episodes while community-acquired AKI represented 29.4% of cases within which 33.9% were admitted to hospital and 30.5% of cases were unclassified. Non-neonatal 30-day mortality was 1.2%, with half of this accounted for by patients treated in the Intensive Care Unit. Nonrecovery of renal function at 30 days occurred in 28% and was significantly higher in patients not admitted to hospital (45% vs. 20%). The reported incidence of AKI in children was far greater than previously reported in studies reliant on clinical identification of adult AKI or hospital coding data. Mortality was highest in neonates and driven by those in the Intensive Care Unit. Nonrecovery of renal function and persistent renal impairment was more common in non-neonates and was especially high in patients with community-acquired AKI who were not hospitalized. |
| Databáze: | OpenAIRE |
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