Acute renal failure in pediatric patients with sepsis

Abstract

Introduction: Assessment of acute renal failure (ARF) development, causative factors and outcomes in pediatric patients with sepsis can facilitate prognosis and early recognition of this condition. Material and methods: Data of 206 pediatric patients (female- 44.7%, male- 55.3%) aged 1 month- 18 years were analysed retrospectively. All patients, treated in the Hospital of Lithuanian University of Health Sciences Kauno klinikos in 2013–2016 because of sepsis, were included in the study. Patients were divided in two groups: I group - sepsis (182), II- sepsis with multiple organ dysfunction (24). Results were compared between groups (p < 0.05). Results: Mean age in groups: I- 4.3 ± 0.36, II- 4.7 ± 1.20 years 196 (95.1%) patients recovered, 10 (4.9%) - died. All cases of death (10/24) were in group II patients (p < 0.001), 7 had ARF (p < 0.001). ARF was diagnosed in 22 (10.7%) patients: I- 5 (2.7%), II- 17 (70.8%) (p < 0.001). 9 (4.4%) patients needed renal replacement therapy. Most patients who had ARF were 1–4 years old (9–40.9%). No significant difference of outcomes was found between patients who had concomitant diseases (59–28.6%) and those who didn’t (147–71.3%) (p = 0.154). Mean value of days from the onset of symptoms to hospitalization in groups: I- 1.9 ± 2.70; II- 0.75 ± 1.03 (p < 0.05). Group II patients were treated in intensive care unit significantlymore often (23–95.8% vs. 66–36.3%) and had longer stays on average (9.62 ± 14.17 vs. 1.3 ± 3.2 days) (p < 0.001). N.meningitidis (5–20.8%) was the prevalent pathogen in blood cultures in group II and among patients with ARF (6–27.3% vs. 8–4.3%) (p < 0.05). Conclusions: 1. Patients with sepsis related multiple organ dysfunction (group II) are diagnosed with ARF significantly more often and have worse overall outcomes. 2. The risk of death in patients with ARF ismore prevalent. 3. N.meningitidis is the leading causative factor of multip [...].