Significant proportion of hospitalized children at increased risk of AKI-associated mortality: AAP

One-fourth of the hospitalized youngsters had acute kidney injury (AKI), which is linked to a higher mortality risk, says an article published in American Academy of Pediatrics.

Due in part to attempts to standardize diagnostic criteria and the introduction of an universal Kidney Disease Improving Global Outcomes (KDIGO) classification in 2012, acute kidney injury (AKI) is more frequently identified in hospitalized children. On the prevalence of acute renal damage and related mortality in hospitalized children, there is scant research. Therefore, Jitendra Meena and team conducted this study in order to comprehensively evaluate the prevalence of AKI among hospitalized children throughout the world in order to assist policymakers in allocating health resources effectively.

Without regard to language or location, three separate databases (Embase, PubMed, and Web of Sciences) were searched between March 2012 and January 2022. Cohort and cross-sectional studies reporting AKI incidence in hospitalized children were taken into consideration by the researchers. Studies that met the criteria for being eligible employed the Kidney Disease Improving Global Outcomes standard criteria to identify AKI and had at least 100 participants. Data on the trial, patients' characteristics, and results (occurrence and AKI-associated mortality) were retrieved, and the risk of bias was evaluated, by two authors. Pooled estimates were created using a random-effects meta-analysis.

The key findings of this study were:

26 nations and 94 studies totaling 202 694 people were included.

Any AKI occurred at a rate of 26% (95% confidence interval: 22-29), and moderate-to-severe AKI at a rate of 14%. (11–16).

Low-middle-income 25% (13-38), low-income 25% (12-39), and high-income 27% (23-32) nations all had comparable rates of AKI occurrence. Overall, 11% (9–13) of the pediatric population had AKI-related death.

The greatest AKI-related death rates were seen in low-income and low-middle-income nations, respectively, at 18% (11-25) and 22% (9-38).

AKI considerably raises the risk of short-term death in hospitalized children and affects a sizeable number of them. Early detection is crucial since AKI has a significant risk of mortality depending on its severity. Variations in epidemiology show that significant political and scientific initiatives, with a special focus on resource-limited nations, are required to achieve the aim of reducing AKI-associated mortality.

Reference: 

Meena, J., Mathew, G., Kumar, J., & Chanchlani, R. (2023). Incidence of Acute Kidney Injury in Hospitalized Children: A Meta-analysis. In Pediatrics. American Academy of Pediatrics (AAP). https://doi.org/10.1542/peds.2022-058823