The epidemiology and prognostic factors of mortality in critically ill children with acute kidney injury in Taiwan

Jei Wen Chang, Mei Jy Jeng, Ling Yu Yang, Tzeng Ji Chen, Shu Chiung Chiang, Wen Jue Soong, Keh Gong Wu, Yu Sheng Lee, Hsin Hui Wang, Chia Feng Yang, Hsin Lin Tsai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

The incidence of acute kidney injury (AKI) in critically ill children varies among countries. Here we used claims data from the Taiwanese National Health Insurance program from 2006 to 2010 to investigate the epidemiological features and identify factors that predispose individuals to developing AKI and mortality in critically ill children with AKI. Of 60,338 children in this nationwide cohort, AKI was identified in 850, yielding an average incidence rate of 1.4%. Significant independent risk factors for AKI were the use of extracorporeal membrane oxygenation, mechanical ventilation or vasopressors, intrinsic renal diseases, sepsis, and age more than 1 year. Overall, of the AKI cases, 46.5% were due to sepsis, 36.1% underwent renal replacement therapy, and the mortality rate was 44.2%. Multivariate analysis showed that the use of vasopressors, mechanical ventilation, and hemato-oncological disorders were independent predictors of mortality in AKI patients. Thirty-two of the 474 patients who survived had progression to chronic kidney disease or end-stage renal disease. Thus, although not common, AKI in critically ill children still has a high mortality rate associated with a variety of factors. Long-term close follow-up to prevent progressive chronic kidney disease in survivors of critical illnesses with AKI is mandatory.

Original languageEnglish
Pages (from-to)632-639
Number of pages8
JournalKidney International
Volume87
Issue number3
DOIs
StatePublished - 1 Mar 2015

Keywords

  • acute kidney injury
  • children
  • critically ill
  • mortality

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