Sepsis-associated acute kidney injury in the paediatric intensive care unit: Frequency and outcomes: Frequency and Outcomes

Objective: To assess the frequency and short-term outcomes of padietric patients admitted with sepsis-associated acute kidney injury (S-AKI) in the paediatric intensive care unit (PICU).Study design: A cross-sectional study. Place and Duration of the Study: Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan, from January 2021 to June 2022.Methodology: Children aged 1 month to 18 years who were admitted to the PICU with a diagnosis of sepsis, based on the International Paediatric Sepsis Consensus (2005), were included. The p-RIFLE criteria was used to label AKI. Patients with chronic kidney disease or missing baseline creatinine at admission were excluded. The Chi-square test was used to study the association between variables. Logistic regression analysis was performed to compare AKI and non-AKI groups for different variables. Results are presented as mean with standard deviations and frequencies with percentages.Results: During the study period, 1,114 patients were admitted to the PICU, of which 394 (35%) had sepsis. Three hundred and twenty-three patients met the inclusion criteria. The mean age of the study population was 2.49 ± 1.40 years, and 56 (17.3%) patients developed AKI. The mean length of PICU stay was 7.04 ± 6.47 days for children with AKI versus 5.24 ± 4.59 days for those without AKI. Of the 56 children with AKI, 44 (78.5%) received mechanical ventilation, and 10 (17.9%) underwent renal replacement therapy (RRT). Overall, 23.8% (n = 77) of patients expired during the study period ¾ 55 (20.59%) from the non-AKI group and 22 (39.22%) from the AKI group. Logistic regression analysis identified several factors associated with AKI, including hypotension at admission or during PICU stay (OR = 2.89, p = 0.002), oliguria (OR = 2.22, p = 0.028), raised BUN (OR = 3.51, p < 0.001), and metabolic acidosis (OR = 2.79, p < 0.001).