Abstract: FR-PO107

Epidemiology of AKI among Hospitalized Children in China

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Nie, Sheng, National Clinical Research Center for Kidney Disease of China, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • Hou, Fan Fan, Nanfang Hospital, Guangzhou, China
  • Xu, Xin, Renal Division, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease, Guangzhou, China
Background

High quality epidemiological data on acute kidney injury (AKI) in children are particularly lacking in Asian countries.

Methods

We performed a nationwide, multicenter study in a cohort of hospitalized children aged 1 month to 18 years from 25 general and children’s hospitals in China during 2013-2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all inpatients who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization. We identified AKI events according to the creatinine criteria of Kidney Disease Improving Global Outcomes.

Results

A total of 20 006 (19.6%) AKI cases were identified among 102 107 pediatric inpatients analyzed, of which 7283 (7.1%) were community acquired and 12 723 (12.5%) hospital acquired. Up to 96% of these AKI events were not diagnosed on the discharge records. The cumulative incidence of AKI in infants (27.6%) doubled that in adolescents (11.9%). The profiles of risk factors differed between CA- and HA-AKI and varied with age. Diarrhea and sepsis were the top risk factors for CA-AKI, contributing to 5.7% and 5.5% of the risk, respectively. Congenital heart disease/cardiac surgery was the major risk factor for HA-AKI, contributing to 18.7% of the risk. Exposure to nephrotoxic drugs, mostly non-steroidal anti-inflammatory drugs and proton pump inhibitors, was common in hospitalized children and associated with an increased risk of AKI. Death occurred in 845 of 20 006 patients (4.2%) with AKI versus 451 of 82 101 children (0.5%) without AKI. The risk of in-hospital death was higher among children with severe AKI, shock and respiratory failure. Pediatric AKI was associated with longer hospital stay and higher daily cost, even after adjustment for covariates.

Conclusion

Pediatric AKI is common with substantial under-diagnosis in China.

Funding

  • Government Support - Non-U.S.