Document Detail


Acute kidney injury in non-critically ill children treated with aminoglycoside antibiotics in a tertiary healthcare centre: a retrospective cohort study.
MedLine Citation:
PMID:  20591815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aminoglycosides (AG) cause acute kidney injury (AKI), but the incidence and severity distribution are unclear, particularly in non-critically ill children. We determined the incidence, severity and risk factors of AG-associated AKI and assessed for associations with longer hospitalization and higher costs.
METHODS: At Texas Children's Hospital, we conducted a retrospective cohort study of children treated with AG for ≥ 5 days in 2005, excluding children with admission primary renal diagnoses. AKI was defined by the paediatric Risk, Injury, Failure, Loss, End Stage Kidney Disease (pRIFLE) and Acute Kidney Injury Network (AKIN) definitions. Multiple logistic and linear regression analyses were used to assess independence of associations with outcomes.
RESULTS: Five hundred and fifty-seven children [mean ± SD age = 8.0 ± 5.9 years, 286 (51%) male, 489 (88%) gentamicin] were studied. The AKI rate was 33% and 20% by pRIFLE and AKIN definitions, respectively. Longer treatment, higher baseline estimated glomerular filtration rate, being on a medicine (versus surgical) treatment service and prior AG treatment were independent risk factors for AKI development. AKI by pRIFLE or AKIN was independently associated with longer hospital stay and higher total hospital costs. The pRIFLE definition was more sensitive for AKI detection, but the AKIN definition was more strongly related to outcomes.
CONCLUSIONS: AKI is common and associated with poorer outcomes in non-critically ill children treated with AG. Future research should attempt to understand how to best define AKI in the non-critical illness paediatric setting.
Authors:
Michael Zappitelli; Brady S Moffett; Ayaz Hyder; Stuart L Goldstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-29
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  26     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-23     Completed Date:  2011-05-12     Revised Date:  2011-12-06    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  144-50     Citation Subset:  IM    
Affiliation:
Division of Nephrology, McGill University Health Centre, Montreal, Canada.
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / drug therapy*,  pathology
Amikacin / therapeutic use*
Anti-Bacterial Agents / therapeutic use*
Child
Child, Preschool
Cohort Studies
Female
Gentamicins / therapeutic use*
Glomerular Filtration Rate
Hospitalization
Humans
Incidence
Infant
Intensive Care Units
Length of Stay
Male
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Tobramycin / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins; 32986-56-4/Tobramycin; 37517-28-5/Amikacin
Comments/Corrections
Comment In:
Nephrol Dial Transplant. 2011 Nov;26(11):3826-7; author reply 3827-8   [PMID:  21878686 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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