Acute Kidney Injury In Children Admitted For Pneumonia In The Emergency Department Of A Government Hospital In The Philippines

Background. Acute kidney injury (AKI) in children increases the risk of adverse outcomes, and its incidence in higher in low-middle income countries—with infectious and diarrheal diseases greatly contributing to its development. The incidence of AKI in patients with pneumonia is poorly described in literature. Objective. This study determined the clinical profile of AKI among children with pneumonia at the emergency department. Methods. Records of 306 patients aged 1 month to 18 years with pneumonia were retrospectively analyzed. The patients were divided into two groups based on presence of AKI using the Kidney Disease Improving Global Outcomes creatinine-based criteria. Clinicodemographic, laboratory and outcome parameters were compared between groups. Logistic regression analysis was performed to identify predictors of AKI. Results. Prevalence of AKI was 19.28%. Moderate-severe dehydration [OR 2202.71, 95% CI 135.37, 35841.88; p < 0.0001] and need for intubation [OR 25.04, 95% CI 6.7, 93.52; p < 0.0001] were the strongest predictors for AKI. Other identified predictors include: age 10 to < 19 years, preterm birth, severe wasting, overweight/obesity, and leukocytosis. Conclusion. There are multiple factors associated with the development of AKI among pediatric patients with pneumonia. Early identification and improved surveillance of those at risk is crucial in reducing the increased morbidity and mortality associated with its occurrence.