ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO597

Prospective Cohort Study of Pediatric AKI in Korea

Session Information

  • Pediatric Nephrology - II
    November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology

Authors

  • Choi, Naye, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Min, Jeesu, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Kim, Ji hyun, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
  • Kang, Haemin, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Kang, Hee Gyung, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Ahn, Yo Han, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
Background

Acute kidney injury (AKI) is a common complication in pediatric patients with underlying disease, and it is associated with increased length of hospital stay and mortality. Additionally, AKI is a well-known risk factor for chronic kidney disease (CKD). Although studies about AKI in children have been increasingly conducted, there was lack of study on the longitudinal kidney outcomes after AKI. Therefore, we conducted a prospective cohort study to investigate the short- and long-term effects of AKI on kidney function in children with AKI.

Methods

A prospective cohort study was performed in hospitalized children who were diagnosed with AKI in Seoul National University Children’s Hospital from February 2016 to July 2021. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Kidney function was assessed at 1, 3, 6, and 12 months after the AKI event and annually thereafter from 1 year

Results

A total of 807 children with AKI were enrolled, and 735 (male 58.2%) patients with follow-up data were analyzed. AKI occurred at the median age of 5.6 (interquartile range (IQR) 1.1–12.1) years. The 85.4% of patients had the underlying disease, including hemato-oncological disease 210 (28.6%), preterm birth 115 (15.6%), and kidney disease 74 (10.1%). Hypertension was present in 107 (14.6%) at the time of AKI. Among them, 415 (56.5%) patients were classified as stage 1, 177 (24.1%) and 143 (19.5%) were classified as stage 2 and 3, respectively. Estimated glomerular filtration rate (eGFR) declined from 102.6 (IQR 70.7–136.6) mL/min/1.73m2 at baseline to 52.8 (IQR 23.9–74.4) mL/min/1.73m2 at the onset of AKI. At follow-up of 1, 3, 6, 12 months, eGFR were 88.9 (IQR 63.5–119.4), 98.3 (IQR 78.2–121.2), 100.5 (IQR 82.0–121.7), and 95.9 (IQR 77.8–113.2) mL/min/1.73m2, respectively. After 12 months, the proportion of eGFR less than 90 and 60 mL/min/1.73m2 were 39.8 % and 8.4%, respectively. The eGFR at follow-up of 12 months was significantly lower than that at baseline (P = 0.007). Older age and hypertension at the AKI event were the risk factors for CKD stage 3.

Conclusion

In this study, 8.4% of children progressed to CKD following AKI. Therefore, it is important to monitor the kidney function in children after an AKI event. Further study is needed to validate risk factors for CKD and longer outcomes.