Original InvestigationPathogenesis and Treatment of Kidney DiseaseLong-term Risk of CKD in Children Surviving Episodes of Acute Kidney Injury in the Intensive Care Unit: A Prospective Cohort Study
Section snippets
Setting, Design, and Participants
We performed a prospective cohort study of patients surviving an episode of AKI in the pediatric ICU at British Columbia Children's Hospital (Vancouver, Canada) from January 2006 to December 2008. The University of British Columbia Ethics Review Board approved the study protocol, and parents/legal guardians provided informed consent before formal enrollment.
Potential study patients were identified through a pediatric ICU admission electronic database. Except for one patient who became dialysis
Patient Characteristics
Baseline ICU admission characteristics for all patients with AKI seen in follow-up (n = 126) compared with those lost to follow-up (n = 173), including demographics, primary diagnoses, ventilation data, measures of illness severity (Pediatric Risk of Mortality [PRISM] III score), and maximal AKIN stage achieved, are listed in Table S1 (available as online supplementary material). Overall, there were no major differences in ICU admission characteristics between these 2 groups except for a
Discussion
The development of standardized AKI definitions has allowed for a more complete understanding of pediatric AKI epidemiology, but the long-term renal outcomes of AKI in critically ill children and neonates have not been well established. Several recent adult studies have shown that those who survive an episode of AKI are at considerable risk of progressing to CKD.30, 31, 32, 33, 34 In prior follow-up studies of pediatric AKI, the incidence of CKD ranges from 27%-66.7%.35, 36, 37, 38, 39, 40, 41
Acknowledgements
An abstract of this study was presented at the American Society of Nephrology (ASN) 43rd Annual Meeting and Scientific Exposition in Denver, CO (November 20, 2010).
Support: This work was supported through the research fellowship training of C.M. (Clinician Investigator Program, University of British Columbia).
Financial Disclosure: The authors declare that they have no other relevant financial interests.
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Originally published online December 30, 2011.