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SURVIVAL AND LONG TERM KIDNEY OUTCOME OF CHILDREN STARTING KIDNEY REPLACEMENT THERAPY IN THE PEDIATRIC INTENSIVE CARE UNIT
- Ramachandran Rameshkumar (India)
Abstract
Background and Aims
To study the survival long-term kidney outcome in children who received kidney replacement therapy (KRT) in a pediatric intensive care unit (PICU).
Methods
Ambidirectional cohort study was conducted in a tertiary care institute from Jan-2015 to Dec-2020. Children aged ≤12-yr who underwent kidney replacement therapy [peritoneal dialysis (PD), continuous kidney replacement therapy (CKRT), and hemodialysis (HD)] were enrolled. Outcome (survived/died) and status of kidney function on follow-up (minimum of 6-to 12-month) were studied. Acute kidney injury was defined using KDIGO criteria.
Results
A total of 117 patients underwent KRT (PD-53.8%, n=63; CKRT-23.1%, n=27; HD-14.5%, n=17;≥2-modalities-8.6%, n=10). Thirty-seven (31.6%) and 80 (68.4%) were survived and died respectively. Median (IQR) PRISM-III and age was 14 (10-21) and 18-month (5-72) respectively. Multiorgan dysfunction was present at admission in 39.3%, shock was in 75.2% and 83.8% received mechanical ventilation. At first follow-up [median (IQR) 6-month (5-8)], abnormal kidney function was present in 8.1% (n=3/37) [stage-I, n=1; stage-II, n=1; stage-III, n=1]. All three patient had stage-1 hypertension. The microscopic hematuria and albuminuria in one patient each respectively. At second follow-up [median (IQR) 16-month (12-21)], abnormal kidney function was present in 2.7% (n=1/37) patient [stage-II, n=1].
Conclusions
Abnormal persistent kidney function was noted in 2.7% during long-term follow-up among survivors who underwent kidney replacement therapy in the pediatric intensive care unit.