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The incidence of pediatric acute kidney injury is increased when identified by a change in a creatinine-based electronic alert

Holmes, Jennifer, Roberts, Gethin, May, Kate, Tyerman, Kay, Geen, John, Williams, John D. and Phillips, Aled O. 2017. The incidence of pediatric acute kidney injury is increased when identified by a change in a creatinine-based electronic alert. Kidney International 92 (2) , pp. 432-439. 10.1016/j.kint.2017.03.009

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A prospective national cohort study was undertaken to collect data on all cases of paediatric (<18yrs of age) AKI identified by an e-alert, using the Welsh National electronic AKI reporting system. We describe the utility and limitation of using this creatinine based data set, to characterise paediatric AKI. There were a total of 1,343 incident episodes. 34.5% of episodes occurred in neonates of which 83.8% were AKI stage 1. Neonatal 30-day mortality was 4.1% with 73.3% of this being accounted for by patients treated in ICU. In the non-neonatal group 76.1% was AKI stage 1. Hospital acquired AKI accounted for 40.1% of AKI episodes. Community acquired AKI represented 29.4% of which 33.9% were admitted to hospital. 30.5% of cases were unclassified. Non-neonatal 30-day mortality was 1.2%, with 50.0% of this accounted for by patients treated in ICU. Nonrecovery of renal function at 30-days occurred in 28% and was significantly higher in patients not admitted to hospital (45% vs. 20%). The reported incidence of AKI in children is far greater than previously reported in studies reliant on clinical identification of adult AKI or hospital coding data. Mortality was highest in neonates and driven by those in ICU. Non-recovery of renal function and persistent renal impairment was more common in non-neonates and was especially high in CA-AKI not hospitalised.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Additional Information: on behalf of the Welsh AKI Steering Group.
Publisher: Elsevier
ISSN: 0085-2538
Date of First Compliant Deposit: 24 March 2017
Date of Acceptance: 2 March 2017
Last Modified: 11 Feb 2021 13:19

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