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ORIGINAL ARTICLE
Year : 2019  |  Volume : 21  |  Issue : 1  |  Page : 51-54

Causes, management practices, and outcomes of pediatric acute kidney injury: A cross-sectional survey


1 Department of Pediatrics and Pediatric Nephrology, SGRR Institute of Medical and Health Sciences, Dehradun, Uttrakhand, India
2 Department of Pediatrics and Pediatric Nephrology, Command Hospital, AFMC, Pune, Maharashtra, India

Correspondence Address:
Lt Col Suprita Kalra
Department of Pediatrics and Pediatric Nephrology, Command Hospital, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmms.jmms_42_18

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Introduction: AKI in critically ill children has multiple etiologies. The primary objective was to study the, causes, management practices and outcomes of AKI in critically ill children as seen by Pediatricians and Pediatric residents in two cities in different parts of India. Methodology: A cross sectional survey using Questionnaire based module with 12 questions was distributed to all participants during a CME at two centers. Results: 50/59 (response rate 84.7%) responded. Only 40% had trained pediatric nephrologist at their centers. 35 (70%) said they saw 1 case of AKI per month. 19/20 at center A believed sepsis with MODS as commonest cause while at center B 14, 21/30 (69.3%) participants selected prerenal causes such as dehydration. Renal causes (14/20, 70%) were commonest indication for dialysis at center A while at center B it was sepsis with AKI. Acute Peritoneal dialysis with stiff catheter was chosen as commonest modality. Complete recovery, persistence of kidney injury, and mortality contributed equally to outcome at center A whereas 56% at center B chose complete recovery. Conclusions: Intrinsic renal causes like HUS are the most common causes of AKI in critically ill children requiring RRT (renal replacement therapy). Despite some advances in infrastructure and training most residents and pediatricians felt that peritoneal dialysis was the commonest modality.


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