Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability

儿童严重脓毒症中的急性肾损伤:死亡和新发残疾的独立危险因素

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作者:Julie C Fitzgerald, Rajit K Basu, Ayse Akcan-Arikan, Ledys M Izquierdo, Byron E Piñeres Olave, Amanda B Hassinger, Maria Szczepanska, Akash Deep, Duane Williams, Anil Sapru, Jason A Roy, Vinay M Nadkarni, Neal J Thomas, Scott L Weiss, Susan Furth; Sepsis PRevalence, OUtcomes, and Therapies Study Inv

Conclusions

In a multinational cohort of critically ill children with severe sepsis and high mortality rates, septic acute kidney injury is independently associated with further increased death or new disability.

Results

One hundred two (21%) of 493 patients had severe acute kidney injury. More than twice as many patients with severe acute kidney injury died or developed new moderate disability compared with those with no/mild acute kidney injury (64% vs 30%; p < 0.001). Severe acute kidney injury was independently associated with death or new moderate disability (adjusted odds ratio, 2.5; 95% CI, 1.5-4.2; p = 0.001) after adjustment for age, region, baseline disability, malignancy, invasive mechanical ventilation, albumin administration, and the pediatric logistic organ dysfunction score. Conclusions: In a multinational cohort of critically ill children with severe sepsis and high mortality rates, septic acute kidney injury is independently associated with further increased death or new disability.

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