An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

Tina L Palmieri, Athina Lavrentieva, David G Greenhalgh

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

Objective: To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Design: Retrospective, descriptive cohort study. Setting: 10-bed burn PICU facility. Patients: All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Measurements and results: Data of 123 patients were studied. The incidence of AKI was 45.5%. Patients with AKI tended to have higher mortality than those without AKI (p = 0.057). All nonsurvivors attained pRIFLE AKI by combination of serum creatinine and urine output criteria. Patients with a more severe form of AKI (Failure and Injury) as well as patients with late AKI had more episodes of sepsis as compared to patients with early AKI and the Risk category of AKI. Logistic regression analysis indicated that PRISM score and TBSA were the independent risk factors for acute kidney injury in pediatric burn patients; the presence of sepsis and septic shock were the independent risk factors for the Failure class of AKI. Conclusion: We observed a high incidence of AKI in the burn PICU population. Sepsis seems to contribute to the development of the Failure class of AKI. Maximum Failure class of AKI is associated with high mortality.

Original languageEnglish (US)
Pages (from-to)2125-2129
Number of pages5
JournalIntensive Care Medicine
Volume35
Issue number12
DOIs
StatePublished - Dec 2009
Externally publishedYes

Keywords

  • Acute kidney injury
  • Burn
  • Critically ill children
  • Mortality
  • RIFLE
  • Risk factors

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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