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<< Acute Kidney Injury in Pediatric Patients: Diagnosis and Management in the Emergency Department (Pharmacology CME)

Disposition

AKI is an independent risk factor for morbidity and mortality, and its identification should be considered, along with the underlying etiology, when planning a patient’s disposition. In a study of 150 critically ill children, Akcan-Arikan et al found that children with AKI (as defined by pRIFLE classification) had significantly longer pediatric ICU and hospital admissions compared to those without AKI; however, the authors of that study did not identify a significantly higher mortality rate in either group, which may be attributable to the relatively small sample size.11 Sutherland et al found 46% of children with AKI admissions were classified as having an extreme likelihood of dying as compared to only 1% of children with non-AKI admissions.1 However, the actual mortality rate among AKI admissions in this sample was 15.3%, compared with 0.6% of non-AKI admissions. Pediatric ICU patients who have AKI have a higher mortality compared to patients without AKI, with risk varying by severity of AKI.5,23

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