Home⇛The PCMC Journal⇛vol. 20 no. 2 (2024)

Short term outcomes of children with acute kidney injury treated with hemodialysis in a tertiary pediatric hospital: a six-year review

Socorro Marie V. Buensalido | Nathan C. Bumanglag

Discipline: medicine by specialism

 

Abstract:

OBJECTIVE: This paper aimed to describe the clinical profile and short-term clinical outcomes of children with Acute Kidney Injury (AKI) requiring hemodialysis in a tertiary pediatric hospital. MATERIALS AND METHODS: A retrospective cohort on in-patients who received hemodialysis treatments at our institution was performed. Medical charts of patients admitted between July 2018 and July 2023 were retrieved. Demographic data, clinical profiles and subsequent outcomes in terms of mortality and recovery or non-recovery from AKI were recorded. RESULTS: After meeting the inclusion and exclusion criteria, 129 patients were included in the study‘s statistical analysis. There was an even distribution between males and females. The average age of treated patients was 10 years old (SD ± 4.3). The average weight of patients was 35kg (SD ± 16.9). The most common diagnosis of patients was severe dengue (21.7%), followed by severe sepsis (14.7%). More than half of patients (51.9%) had an existing co-morbidity, of which Systemic Lupus Erythematosus (22.4%) and solid tumors (22.4%) were most common. The most common indication for hemodialysis was uremia (52.7%). In terms of short-term outcome, majority of patients died during the same admission (56.5%), while 31 patients (24.0%) recovered. CONCLUSION: The clinical profile of patients who underwent hemodialysis treatments for AKI were comparable to international data. The study did not differentiate deaths from AKI or underlying illness, but demonstrated a higher mortality rate compared to other existing studies. This study is the first known local paper to describe the profile and outcomes of children who received hemodialysis for AKI.



References:

  1. Philippine Pediatric Society, Inc. – A Specialty Division of the Philippine Medical Association (PMA) [Internet]. Pediatric Nephrology Society of the Philippines Census Report; 2022 [cited 2023 Sep 1]. Available from: https://pps.org.ph/wp-content/uploads/2023/03/PNSP-2022-Renal-Registry.pdf 
  2. Devarajan, P. (n.d.). Acute kidney injury in children: Clinical features, etiology, evaluation, and diagnosis. UpToDate. https://www.uptodate.com/contents/acute-kidney-injury-in-children-clinical-features-etiology-evaluation-and-diagnosis?search=aki+pediatric&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H694161131 [cited 2023 August]. Available from: https://www.uptodate.com/contents/acute-kidney-injury-in-children-clinical-features-etiology-evaluation-and-diagnosis 
  3. Emma, Francesco; Goldstein, Stuart L.; Bagga, Arvind; Bates, Carlton M.; Shroff, Rukshana. Pediatric Nephrology. [place unknown]: Springer; [date unknown]. 2500 p.
  4. Benz, Marcus R.; Schaefer, Franz. Pediatric Dialysis [Internet]. Boston, MA: Springer US; 2011. Technical Aspects of Hemodialysis in Children; [cited 2023 September]; p. 287-311. Available from: https://doi.org/10.1007/978-1-4614-0721-8_17 
  5. Uber, Amanda M.; Sutherland, Scott M. Acute kidney injury in hospitalized children: consequences and outcomes. Pediatr Nephrol [Internet]. 2018 Nov 1 [cited 2023 August];35(2):213-220. Available from: https://doi.org/10.1007/s00467-018-4128-7
  6. Asinobi, Adanze O.; Ademola, Adebowale D.; Alao, Michael A. Haemodialysis for paediatric acute kidney injury in a low resource setting: experience from a tertiary hospital in South West Nigeria. Clin Kidney J [Internet]. 2015 Nov 14 [cited 2023 August];9(1):63-68. Available from: https://doi.org/10.1093/ckj/sfv112 
  7. 7. Brophy, Patrick D. Renal Supportive Therapy for Pediatric Acute Kidney Injury in the Setting of Multiorgan Dysfunction Syndrome/Sepsis. Semin Nephrol [Internet]. 2008 Sep [cited 2023 August 9];28(5):457-469. Available from: https://doi.org/10.1016/j.semnephrol.2008.05.005 
  8. Howard, Scott C.; Jones, Deborah P.; Pui, Ching-Hon. The Tumor Lysis Syndrome. New Engl J Med [Internet]. 2011 May 12 [cited 2023 August];364(19):1844-1854. Available from: https://doi.org/10.1056/nejmra0904569 
  9. Lebel, Asaf; Teoh, Chia W.; Zappitelli, Michael. Long-term complications of acute kidney injury in children. Curr Opin Pediatr [Internet]. 2020 Jun [cited 2023 September 9];32(3):367-375. Available from: https://doi.org/10.1097/mop.0000000000000906 
  10. Shin, Hyun-Seung; Oh, Ji Young; Park, Se Jin; Kim, Ji Hong; Lee, Jae Seung; Shin, Jae Il. Outcomes of Hemodialysis in Children: A 35-Year Experience at Severance Hospital. Yonsei Med J [Internet]. 2015 [cited 2023 September];56(4):1007. Available from: https://doi.org/10.3349/ymj.2015.56.4.1007 
  11. 11. Olowu, Wasiu A.; Niang, Abdou; Osafo, Charlotte; Ashuntantang, Gloria; Arogundade, Fatiu A.; Porter, John; Naicker, Saraladevi; Luyckx, Valerie A. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: a systematic review. Lancet Glob Health [Internet]. 2016 Apr [cited 2023 September];4(4):e242-e250. Available from: https://doi.org/10.1016/s2214-109x(15)00322-8 
  12. 12. Keita, Younoussa; Ndongo, Aliou A.; Ly, Fatou; Cisse, Ndeye C.; Yamba, Liliane N. D. M.; Niang, Babacar; Seck, Djiby; Sow, Amadou; Sow, Ndeye F.; Ba, Abou; Ly, Indou D.; Thiongane, Aliou; Fall, Amadou L.; Ba, Idrissa D.; Gueye, Modou; Faye, Pape M.; Sylla, Assane. Prevalence of Renal Failure in Children and the Need for Dialysis in Paediatric Nephrology in a Developing Country. Open J Nephrol [Internet]. 2022 [cited 2023 September];12(01):101-111. Available from: https://doi.org/10.4236/ojneph.2022.121010 
  13. 13. Sethi, Sidharth Kumar; Bunchman, Timothy; Raina, Rupesh; Kher, Vijay. Unique Considerations in Renal Replacement Therapy in Children: Core Curriculum 2014. Am J Kidney Dis [Internet]. 2014 Feb [cited 2023 September];63(2):329-345. Available from: https://doi.org/10.1053/j.ajkd.2013.08.018 
  14. 1Fischbach, M.; Edefonti, A.; Schröder, C.; Watson, A. Hemodialysis in children: general practical guidelines. Pediatr Nephrol [Internet]. 2005 Jun 10 [cited 2023 September];20(8):1054-1066. Available from: https://doi.org/10.1007/s00467-005-1876-y 
  15. Robinson, Cal; Hessey, Erin; Nunes, Sophia; Dorais, Marc; Chanchlani, Rahul; Lacroix, Jacques; Jouvet, Philippe; Phan, Veronique; Zappitelli, Michael. Acute kidney injury in the pediatric intensive care unit: outpatient follow-up. Pediatr Res [Internet]. 2021 Mar 17 [cited 2023 September]. Available from: https://doi.org/10.1038/s41390-021-01414-9 
  16. Lameire, Norbert; Van Biesen, Wim; Vanholder, Raymond. Epidemiology of acute kidney injury in children worldwide, including developing countries. Pediatr Nephrol [Internet]. 2016 Jun 15 [cited 2023 September];32(8):1301-1314. Available from: https://doi.org/10.1007/s00467-016-3433-2 
  17. Gameiro, Joana; Marques, Filipe; Lopes, José António. Long-term consequences of acute kidney injury: a narrative review. Clin Kidney J [Internet]. 2020 Nov 19 [cited 2023 September]. Available from: https://doi.org/10.1093/ckj/sfaa177 
  18. 18. Acute Kidney Injury in Critically Ill Children and Young Adults. New Engl J Med [Internet]. 2017 Mar 30 [cited 2023 September];376(13):1294-1296. Available from: https://doi.org/10.1056/nejmc1701196 
  19. McCulloch, Mignon; Luyckx, Valerie A.; Cullis, Brett; Davies, Simon J.; Finkelstein, Fredric O.; Yap, Hui Kim; Feehally, John; Smoyer, William E. Challenges of access to kidney care for children in low-resource settings. Nat Rev Nephrol [Internet]. 2020 Oct 1 [cited 2023 September];17(1):33-45. Available from: https://doi.org/10.1038/s41581-020-00338-7 

Tools


Copyright © 2025  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic