TỶ LỆ VÀ NGUYÊN NHÂN GÂY TỔN THƯƠNG THẬN CẤP Ở TRẺ EM TẠI KHOA ĐIỀU TRỊ TÍCH CỰC NỘI KHOA, BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: To determine the prevalence and underlying causes of acute kidney injury (AKI) in pediatric patients admitted to the Pediatric Intensive Care Unit at the Vietnam National Children’s Hospital. Subjects and Methods: This was a descriptive cross-sectional study conducted on 204 pediatric patients aged 1 month to 17 years who were admitted to the PICU from November 2024 to March 2025 and remained hospitalized for at least 72 hours. AKI was diagnosed and staged according to the KDIGO 2012 criteria using serum creatinine levels. Baseline serum creatinine was estimated assuming a normal glomerular filtration rate (eGFR) of 100 mL/min/1.73m². Results: AKI was diagnosed in 26.0% of patients within the first 24 hours of admission. The cohort of patients aged less than 12 months demonstrated the highest prevalence of acute kidney injury (AKI), accounting for 37.7%, and constituted 75.5% of all AKI cases. Among the 151 patients without AKI at 24 hours after admission, 13.2% developed new-onset AKI by 72 hours. Of the 53 pediatric patients diagnosed with AKI at 24 hours, the improvement rates in AKI severity after 72 hours of treatment were 70.6%, 58.9%, and 73.7% for KDIGO stages I, II, and III, respectively. The most frequent underlying conditions in AKI patients were respiratory diseases (37.7%), sepsis (30.2%), and cardiovascular diseases (17.0%). Conclusion: AKI is a common complication among pediatric patients admitted to intensive care units, particularly in infants under 12 months of age and those with underlying respiratory, infectious, or cardiovascular conditions. Early screening and close monitoring of renal function in high-risk groups are essential for timely intervention and improving clinical outcomes.