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Kidney Week

Abstract: SA-PO600

Predictive Factors of Mortality in Pediatric Patients With AKI Hospitalized in a Tertiary Hospital

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

  • Vieira, Simone, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Carvalho, Maria fernanda Camargo, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Gago, Paloma Cals, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Hatanaka, Eduardo Freitas, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Macedo, Karina Melo, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Dos Santos, Ana Carolina Almenara Pelisson Lucas, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Pacheco, Pollyanna Santos, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Miranda, Renata Lustosa Garcia de, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
  • Koch Nogueira, Paulo C., Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil
Background

Retrospective analysis of risk factors associated with death in pediatric patients hospitalized in the intensive care unit (ICU) of Samaritano Higienópolis Américas Hospital from January 2016 to April 2022, with indication of dialysis, taking into account the etiology of Kidney disease, clinical and demographic characteristics.

Methods

We evaluated 235 patients (6 on peritoneal dialysis - PD, 102 on continuous hemodialysis - CRRT and 127 on conventional hemodialysis - HDC). The patients were grouped into: survivors and death. To evaluate the predictive factors of death, univariate logistic regression analysis was used with the outcome death, and the following risk variables: age, gender, etiology of kidney disease, Fluid overload, use of diuretics, vasoactive drugs, and time of ICU stay until consultation with nephrologist.

Results

Of the 235 patients included in the study, 63 (27%) died and 172 (73%) survived until hospital discharge, 176 (75%) were male, 157 (67%) had kidney disease, 51 (22%) had oncologic disease, 17 (7%) were cardiac. The median age was 5 years (interquartile range 1.4 to 10.0) and the risk factors significantly associated with the outcome death were: Fluid overload (FO%) (OR= 1.07, 95% CI 1.03-1.1, p<0.001), age (OR= 0.91, 95% CI 0.86-0.97, p 0.002), according to the underlying disease: Oncologic (OR= 8.31, 95% CI 4.18- 16.51), p <0.01), cardiac (OR= 26.56, 95%CI 5.87- 120.21, p <0.001), kidney (OR= 0.05, 95% CI 0.02- 0.11, p< 0.001), use of vasoactive drugs (OR = 13.47 95% CI 6.2- 29.28, p < 0.001) and ICU stay to initiate dialysis (OR= 1.1, 95% CI 1.05 - 1.15, p<0.001),

Conclusion

In this study the variables that were associated with the highest risk of death were : underlying disease, with a higher chance of death for heart disease (increased risk of death by 26.56 times) and oncological (increased risk of 8 times), patients with Kidney disease had a protective effect for death, age (each year of increase reduces the risk of death by 9%), use of vasoactive drugs (increased death by 13.5 times), ICU stay (each day the most increased the risk of death by 10%) and Fluid overload (each 1% FO increased the risk of death by 7%).