FREQUENCY, RISK FACTORS, AND OUTCOMES OF ACUTE KIDNEY INJURY IN CHILDREN WITH SEPSIS ADMITTED TO PAEDIATRIC INTENSIVE CARE UNIT

Abstract

Objective: To assess the incidence, risk factors and clinical consequences of acute kidney injury (AKI) in paediatric sepsis patients in the Paediatric Intensive Care Unit (PICU).

Study Design: Prospective observational study.

Place and Duration of Study: At Paediatric Intensive Care Unit (PICU) of Children Hospital and Institute of Child Health, Multan from January 2025 to November 2025.

Methodology: 288 neonates and children were recruited, based on the WHO prevalence formula. Inclusion criteria were children who were diagnosed with sepsis and admitted to the PICU while those who had chronic kidney disease were excluded. Demographic, clinical and laboratory data were taken. AKI was defined using the usual paediatric criteria. Data was analysed using frequency distribution, risk factor assessment and correlation of outcomes using appropriate tests.

Results: AKI was observed in a significant number of patients (288 patients). The most frequently observed risk factors were hypotension, failure to start therapy and multi-organ dysfunction. There was a correlation between AKI and higher mortality, longer PICU stay and requirement for renal replacement therapy. Early recognition and early intervention had a great impact on the outcomes.

Conclusion: AKI is common and a severe complication seen in patients with paediatric sepsis. Early recognition of patients at risk and use of intensive management are important to minimize morbidity and mortality in the PICU setting.