Epidemiology Of Acute Kidney Injury In PICU And Neutrophil Gelatinase-associated Lipocalin For Early Diagnosis

Objective We conducted this epidemiological survey to evaluate the importance of AKI in Paediatric intensive care units(PICU). The objectives of this study were to determine the incidence of AKI in PICU patients and to determine the influencing factors of the development of AKI and the patients’ outcomes. And we examined neutrophil gelatinase-associated lipocalin(NGAL) for early diagnosis of AKI.Methods In a retrospective observational study, 240 children admitted to PICU from Jan. to Dec. in 2014 were enrolled. The patients were diagnosed by KDIGO? AKI Guideline 2012. We analysed the morbidity, treatment modality and outcome data of patients to determine the influencing factors. And we also examined neutrophil gelatinase-associated lipocalin(NGAL) in 21 patients for early diagnosis of AKI.Results Fifty-seven patients(23.7%) had AKI in total. By AKIN criteria 14.6% had Stage 1, 3.8% had Stage 2 and 5.4% had Stage 3. In 58% of patients, AKI was associated with sepsis. Children with AKI had longer length of PICU stay and length of hospital stay, more medical costs, higher mortality than those without AKI(P<0.05). High level in CRP and Lac were the independent risk factors for development of AKI on the multiple logistic regression model. And in the NGAL examination, NGAL level rised in all AKI patients and part of the non-AKI patients at the first day. The level could change immediately as the treatment proceeded.Conclusions Acut kidney injury is common among children admitted to PICU. Sepsis is an important influencing factors for AKI. High level in CRP and Lac were the independent risk factors for development of AKI and NGAL was a sensitive biomarker for early diagnosis of AKI...