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Long-term kidney outcomes in children following continuous kidney replacement therapy.
Frisby-Zedan, Jeanne; Barhight, Matthew F; Keswani, Mahima; Arzu, Jennifer; Nelson, Delphine.
Afiliação
  • Frisby-Zedan J; Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA. jfrisbyzedan@luriechildrens.org.
  • Barhight MF; Northwestern University Feinberg School of Medicine, Chicago, IL, USA. jfrisbyzedan@luriechildrens.org.
  • Keswani M; Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA.
  • Arzu J; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Nelson D; Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA.
Pediatr Nephrol ; 38(2): 565-572, 2023 02.
Article em En | MEDLINE | ID: mdl-35552525
BACKGROUND: Continuous kidney replacement therapy (CKRT) is a mainstay of therapy for management of severe acute kidney injury (AKI) in critically ill pediatric patients. There is limited data on the risk of chronic kidney disease (CKD) after discharge in this population. METHODS: This is a single-center, retrospective cohort study of all pediatric patients ages 0-17 years who received CKRT from 2013 to 2017. The study excluded patients with pre-existing CKD, those who died prior to discharge, and those who had insufficient follow-up data. Patients were followed after hospital discharge and electronic health record data was collected and analyzed to assess for incidence of and risk factors for kidney sequelae. RESULTS: A total of 42 patients were followed at a median time of 27 months (IQR 17.2, 39.8). Of these, 26.2% had evidence of CKD and 19% were at risk for CKD. Lower eGFR at hospital discharge was associated with increased odds of kidney sequelae (aOR 0.985; 95% CI 0.972, 0.996). Ages 0- < 1 and 12-17 were not significantly different (aOR 0.235, 95% CI 0.024, 1.718) and had the highest incidence of kidney sequelae (50% and 77%, respectively). Ages 1-5 and 6-11 had a decreased odds of kidney sequelae compared to the 12-17 year age group (aOR 0.098; 95% CI 0.009, 0.703 and aOR 0.035; 95% CI 0.001, 0.39, respectively). Only 54.8% of patients (n = 23) were seen in the nephrology clinic after discharge. CONCLUSIONS: Patients who receive CKRT for AKI have a significant risk of CKD, while follow-up with a pediatric nephrologist in these high-risk patients is sub-optimal. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Renal Crônica / Injúria Renal Aguda / Terapia de Substituição Renal Contínua Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Renal Crônica / Injúria Renal Aguda / Terapia de Substituição Renal Contínua Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans / Infant / Newborn Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos