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Review paper

Outcomes of acute kidney injury in critically ill children who need renal replacement therapy

By
Danka Pokrajac Orcid logo ,
Danka Pokrajac
Contact Danka Pokrajac

Paediatric Clinic, University Clinical Centre Sarajevo , Sarajevo , Bosnia and Herzegovina

Admir Hadžimuratović ,
Admir Hadžimuratović

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Ismeta Kalkan ,
Ismeta Kalkan

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Nedim Begić ,
Nedim Begić

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Emina Hadžimuratović ,
Emina Hadžimuratović

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Verica Mišanović ,
Verica Mišanović

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Duško Anić ,
Duško Anić

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Aida Mustajbegović-Pripoljac
Aida Mustajbegović-Pripoljac

Paediatric Clinic, Clinical Centre University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Abstract

Aim
To determine an outcome of acute kidney injury (AKI) in critically ill children (CIC) who needed renal replacement therapy
(RRT) and were admitted to the Paediatric and Neonatal Intensive Care Unit (PICU and NICU) at the Paediatric Clinic, University Clinical Centre Sarajevo (UCCS).
Methods
The research included 81 children with AKI. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define
AKI was used. Other laboratory findings and imaging tests were made depending on children’s primary disease that led to the AKI.
Results
Among 81 children with AKI, 38 were girls and 43 boys. A total of 39 (48.1%) patients died; the death was due to the nature of the primary disease and multiple organ failure syndromes. Out of the total of 81 patients the highest mortality rate was found in children in the first year of life, 22 (56.4%), while 17 (43.6%) patients died after the first year of life.
Conclusion
Without an accurate diagnosis at the right time, due to the lack of adequate biomarkers for AKI screening, the heterogeneity of AKI, comorbidities often lead to unfavourable outcomes of the disease, among CIC, especially in infants with low birth
weight and extreme immaturity. Some causes of AKI are preventable and can be reduced by a better organization of primary and secondary health care.

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