AETIOLOGY AND OUTCOME OF PAEDIATRIC ACUTE KIDNEY INJURY IN A TERTIARY HOSPITAL IN EASTERN INDIA

BACKGROUND Acute kidney injury is an important cause of mortality and morbidity in children. The aetiology varies between countries and the incidence is in increasing trend. In developing countries, there is difficulty in providing dialysis which affects the outcome of AKI. The purpose of the study was to describe the aetiology and outcome of acute kidney injury in 1 month to 12 years children admitted in children ward and PICU of a tertiary hospital. MATERIALS AND METHODS The study was done by retrospective analysis of medical records of 4320 children admitted in children's ward and PICU of a tertiary hospital over a period of one year from July 2016 to June 2017. RESULTS Among 4320 children admitted, we had 88 cases of AKI with a prevalence of 20.3 per 1000 admitted children. Mean age was 5.53 +/- 3.93 years with a range of 38 days to 12 years. 87.5% cases were community acquired. Intrinsic renal AKI (52.2%, n=46) was the major mechanism. Gastroenteritis ( 33%, n=29) and AGN (10.2%, n=9) were the common aetiologies. Severity of AKI measured according to pRIFLE criteria showed the proportion of children in the categories of risk, injury and failure were almost equal. Mortality was 11.7%, about half occurring in children in whom dialysis was not provided due to technical issues. CONCLUSION This study concluded that prevalence of AKI is increasing. Gastroenteritis was the most important cause. Mortality can be reduced with better access to dialysis.