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Kidney Week

Abstract: FR-PO033

The Incidence and Frequency of Diagnosing AKI in Non-Critically Ill Pediatric Patients

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Pham, Tai Minh, Valley Children''s Hospital, Fresno, California, United States
  • Tzeng, Julia W., Valley Childrens Hospital, Madera, California, United States
  • Jinadu, Laide, Valley Childrens Hospital, Madera, California, United States
Background

Acute kidney injury (AKI) is commonly seen among hospitalized pediatric patients. Most studies have focused on critically ill patients and the incidence in non-critically ill (NCI) patients is less well studied. There has been only one study, McGregor et al (2016), that has looked at the incidence of AKI in this population and no studies evaluating the frequency of AKI diagnosis during NCI admissions. McGregor et al found that the rate of AKI among NCI patients to be 5%. The purpose of our study is to validate the finding of McGregor et al. and to assess the frequency of provider diagnosis of AKI in NCI patients during admission.

Methods

We performed a retrospective cohort study on all patients admitted to the NCI hospitalist service at our tertiary care pediatric hospital between July 1 2017 and June 31 2018. Patients included in the study were between the ages of 2 weeks and 18 years without history of chronic kidney disease or intensive care unit admission at any time of their hospitalization, and who had 2 or more serum creatinine values. We used the KDIGO criteria, defined as serum creatinine increase by ≥0.3mg/dL within 48 hours or increase by ≥1.5 times the baseline within 7 days, to identify patients with AKI. Of those identified with AKI, we reviewed the chart to assess whether providers had identified the AKI during the admission.

Results

Of the 14,495 patients admitted, 1,223 (8%) patients were included in the study. 132 (10.8 %) patients met the KDIGO criteria for AKI. Of these 132 patients, only 51 (37.8%) were identified to have AKI by providers during their admission.

Conclusion

Our study suggests that the incidence of AKI in the NCI setting is higher than previously reported; 10.8% of NCI patients in our institution had AKI, compared to the 5% reported by McGregor et al. Since we were only able to analyze 8% of the total patients admitted, due in part to lack of data, it is possible that the rate of AKI is even higher. This shows the limitations of applying the KDIGO criteria in diagnosing AKI in the clinical setting. We also found the frequency of identifying AKI was low at 37.8%. As prompt identification of AKI is crucial in preserving kidney function, new strategies are needed to help providers identify these patients.