18 Nov Acute Kidney Injury Linked To Increased Mortality in Critically Ill Children and Young Adults
MedicalResearch.com Interview with:
Dr. Stuart L. Goldstein
Stuart L. Goldstein, MD, FAAP, FNKF
Clark D. West Endowed Chair
Professor of Pediatrics
University of Cincinnati College of Medicine
Director, Center for Acute Care Nephrology | Associate Director, Division of Nephrology
Medical Director, Pheresis Service | Co-Medical Director, Heart Institute Research Core
Division of Nephrology and Hypertension | The Heart Institute
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH 45229
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This was a prospective international multi-center assessment of the epidemiology of acute kidney injury in children in young adults. Over 5,000 children were enrolled from 32 pediatric ICUs in 9 countries on 4 continents.
The main findings are:
1) Severe AKI, defined by either Stage 2 or 3 KDIGO serum creatinine and urine output criteria carried an incremental risk of death after adjusting for 16 co-variates.
2) Patients with AKI by low urine output would have been misclassified as not having AKI by serum creatinine criteria and patients with AKI by urine output criteria have worse outcomes than patients with AKI by creatinine crtieria.
3) Severe AKI was also associated with increased and prolonged mechanical ventilation use, increased receipt of dialysis or ECMO
MedicalResearch.com: What should readers take away from your report?
Response: Since children do not have the chronic systemic disease seen in adults, such as diabetes, cirrhosis, heart failure and chronic kidney disease, our pediatric study suggests that AKI itself is mediating the increased mortality. In addition, we argue that it is extremely important to accurately measure urine output to use the entire KDIGO classification criteria and not just rely on serum creatinine.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Given the early development of AKI in critically ill children and the associated mortality, we will work to enhance our ability to predict severe earlier and validate novel diagnostic and therapeutic interventions early in the ICU course to improve outcome for the critically ill child with, or at-risk for, acute kidney injury.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on November 18, 2016 by Marie Benz MD FAAD