This study was conducted by adhering to the strategy proposed by the International Society of Nephrology (ISN): zero preventable deaths by 2025 (0by25) and aimed mainly at developing countries. The aim of this study was to describe the prognosis of AKI patients admitted to PICU, besides associated complications and mortality in medium-complexity levels of care (II and III) from the Colombian southeast. Mortality rate has been related with shock status, major cardiac abnormalities, presence of sepsis, use of renal replacement therapy (RRT), and use of mechanical ventilation. By using the KDIGO classification, the authors reported factors, such as dehydration, presence of shock, and use of nephrotoxic drugs as the most common potential causes of AKI. It included 905 patients, but only reports data from 21 patients who were under 18 years of age and almost no patients from Colombia. The AKI Committee of the Latin American Society of Nephrology and Hypertension (SLANH, for the term in Spanish) conducted an epidemiological study in Latin America and the Caribbean to assess the AKI profile according to geographic distribution and its relationship with social conditions. However, lack of unified data is still the case regarding epidemiology distribution and outcomes in Colombia and information on pediatric population is available mainly from high-complexity hospitals in big cities. Prognosis has been related with age of the patients, presence of infection, use of inotropic agents and mechanical ventilation, as well as, nutritional and socioeconomic status, and availability of health care services.
In Colombia, retrospective studies have been carried out in high-complexity PICU seeking to stablish the outcomes of AKI patients. Additionally, in medium- and low-complexity levels, hypotension, dehydration, and sepsis are the most important factors. Sepsis is one the main causes of AKI in children and its incidence has been described between 9% and 34%. Therefore, in highly complex PICU, the main characteristics described are sepsis, organ transplants, and cardiovascular surgery.
Potential causes of AKI in pediatric intensive care units (PICU) vary according to demographic or health characteristics and differ according to the level of complexity of care. In Colombia, studies have described an overall incidence from 5% to 11.5% and associated mortality from 31.8% to 53%. The AWARE study reported 26% (95% CI, 25.6 to 28.2) incidence of global AKI and 11% (95% CI, 10.7 to 12.5) of severe AKI developed during the first week of hospital stay in pediatric intensive care. Incidence and prevalence of AKI in children are widely variable due to multiple factors that influence upon the development and the course of the disease. The disease is associated with morbidity, prolonged hospital stay, and high risk of mortality. It occurs frequently in hospitalized pediatric patients and in greater numbers in critically ill patients. It is currently classified by following the Kidney Disease Improving Global Outcomes (KDIGO classification). Calvache, Investigation, Methodology, Project administration, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing # 5, 6Īcute kidney injury (AKI) is a syndrome defined by a rapid increase in serum creatinine, decrease in urine output, or both. Castillo, Conceptualization, Investigation, Resources, 3, ‡ Stefany Tetay, Conceptualization, Data curation, 3, ‡ Natalia Cabal, Conceptualization, Data curation, 2, ‡ and José A. Lasso, Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – original draft, Writing – review & editing, # 4 Eliana Zemanate, Project administration, Supervision, Writing – original draft, 2, ‡ Yessica Bravo, Investigation, Project administration, Supervision, Writing – original draft, 2, ‡ Gastón E.
Forero-Delgadillo, Data curation, Formal analysis, Investigation, Project administration, Supervision, Visualization, Writing – original draft, Writing – review & editing, # 1, * Rubén E. Mondragon, Conceptualization, Investigation, Writing – original draft, Writing – review & editing, # 2 Jessica M. Restrepo, Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing, # 1 Mónica V.