|
1
|
Zarei H, Azimi A, Ansarian A, Raad A, Tabatabaei H, Roshdi Dizaji S, Saadatipour N, Dadras A, Ataei N, Hosseini M, Yousefifard M. Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis. BMC Nephrol 2025; 26:117. [PMID: 40045255 PMCID: PMC11883935 DOI: 10.1186/s12882-025-04033-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Accepted: 02/20/2025] [Indexed: 03/09/2025] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a significant health concern in hospitalized children and is associated with increased mortality. However, the true burden of AKI-associated mortality in pediatric populations remains unclear. OBJECTIVE To determine the pooled incidence of mortality independently associated with AKI in hospitalized children globally. DATA SOURCES Medline and Embase were searched for studies published by March 2024. STUDY ELIGIBILITY CRITERIA The inclusion criteria encompassed observational studies involving hospitalized pediatric patients (< 18 years old) with AKI. Only studies that identified AKI as an independent risk factor for increased mortality in multivariate analysis were considered. STUDY APPRAISAL AND SYNTHESIS METHODS Studies with at least 100 AKI patients were included in the meta-analysis. Two authors extracted data on the study and patients' characteristics and mortality across AKI stages and assessed the risk of bias. We used a random-effects meta-analysis to generate pooled estimates of mortality. RESULTS Analysis of 60 studies including 133,876 children with AKI revealed a pooled in-hospital mortality rate of 18.27% (95% CI: 14.89, 21.65). Mortality increased with AKI severity; 8.19% in stage 1, 13.44% in stage 2, and 27.78% in stage 3. Subgroup analyses showed no significant differences across geographical regions, income levels, or AKI definition criteria. The pooled post-discharge mortality rate was 6.84% (95% CI: 5.86, 7.82) in a 1-9-year follow-up period. CONCLUSIONS This meta-analysis demonstrates a substantial global burden of AKI-associated mortality in hospitalized children, with higher mortality rates in more severe AKI stages. These findings highlight the critical need for early detection and intervention strategies in pediatric AKI management. CLINICAL TRIAL NUMBER Not applicable.
Collapse
Affiliation(s)
- Hamed Zarei
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Amir Azimi
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Arash Ansarian
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Arian Raad
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Hossein Tabatabaei
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Shayan Roshdi Dizaji
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Narges Saadatipour
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Ayda Dadras
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran
| | - Neamatollah Ataei
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Poursina Ave. Enqhelab St., Tehran, Iran.
| | - Mahmoud Yousefifard
- Physiology Research Center, Iran University of Medical Sciences, Hemmat Highway, P.O Box: 14665-354, Tehran, Iran.
| |
Collapse
|
|
2
|
Sethi SK, Raina R, Sawan A, Asim S, Khant AK, Matnani M, Ganesan K, Lohia S, Sinha R, Rumana J, Haque SS, Kalra S, Safdar R, Prasad G, Ijaz I, Ashruf OS, Nair A, S S, Soni K, Shrestha D, Yadav S, Abeyagunawardena A, Luyckx VA, Alhasan KA, Sultana A. RETRACTED ARTICLE: Assessment of South Asian Pediatric Acute Kidney Injury: Epidemiology and Risk Factors (ASPIRE)-a prospective study on "severe dialysis dependent pediatric AKI". Pediatr Nephrol 2024; 39:3453. [PMID: 38456915 DOI: 10.1007/s00467-024-06324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Sidharth Kumar Sethi
- Department of Pediatric Nephrology and Pediatric Kidney Transplantation, Kidney and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India.
| | - Rupesh Raina
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA
- Department of Nephrology, Akron Children's Hospital, Akron, OH, USA
| | - Ahmad Sawan
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA
| | - Sadaf Asim
- National Institute of Child Health, Karachi, Pakistan
| | | | - Manoj Matnani
- Department of Pediatrics, Dr. D.Y Patil Medical College and Hospital, Pune, Maharashtra, India
| | | | - Shraddha Lohia
- Bharati Vidyapeeth Deemed University, Pune, Maharashtra, India
| | - Rajiv Sinha
- Division of Paediatric Nephrology, Institute of Child Health, Kolkata, West Bengal, India
| | | | - Syed Saimul Haque
- Bangabandhu Sheikh Mujib Medical University Hospital, Dhaka, Bangladesh
| | - Suprita Kalra
- Army Hospital Research and Referral, New Delhi, India
| | - Rabia Safdar
- Department of Pediatric Nephrology, Nishtar Medical University, Multan, Pakistan
| | - Gopal Prasad
- Department of Nephrology, Patna Medical College and Hospital, Patna, India
| | - Iftikhar Ijaz
- Children Kidney Center, Department of Pediatrics, King Edward Medical University, Lahore, Pakistan
| | - Omer S Ashruf
- Department of Internal Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Aishwarya Nair
- Department of Pediatric Nephrology and Pediatric Kidney Transplantation, Kidney and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India
| | - Savita S
- Department of Pediatric Nephrology and Pediatric Kidney Transplantation, Kidney and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India
| | - Kritika Soni
- Department of Pediatric Nephrology and Pediatric Kidney Transplantation, Kidney and Urology Institute, Medanta, The Medicity Hospital, Gurgaon, India
| | | | | | - Asiri Abeyagunawardena
- Department of Paediatrics, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Valerie A Luyckx
- Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Paediatric and Child Health, University of Cape Town, Cape Town, South Africa
| | - Khalid A Alhasan
- Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Azmeri Sultana
- Dr. MR Khan Children's Hospital and Institute of Child Health, Dhaka, Bangladesh
| |
Collapse
|
|
3
|
Raina R, Myneni A, Sethi SK. Caregiver burden in pediatric acute kidney injury and chronic kidney disease. Pediatr Res 2024; 96:540-542. [PMID: 38600302 DOI: 10.1038/s41390-024-03198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/08/2024] [Accepted: 03/23/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Rupesh Raina
- Department of Nephrology, Akron Children's Hospital, Akron, OH, USA.
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA.
| | - Archana Myneni
- Department of Nephrology, Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA
| | - Sidharth K Sethi
- Department of Pediatric Nephrology, Kidney Institute, Medanta, The Medicity, Gurgaon, Haryana, India
| |
Collapse
|
|
4
|
Chirico V, Chimenz R. Renal Biomarkers and Novel Therapies in Pediatric Nephrology: From Chronic Kidney Disease to Renal Transplantation. J Clin Med 2023; 12:jcm12113810. [PMID: 37298005 DOI: 10.3390/jcm12113810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Chronic kidney disease (CKD), a growing problem with an estimated prevalence of 74 [...].
Collapse
Affiliation(s)
- Valeria Chirico
- Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy
| | - Roberto Chimenz
- Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy
| |
Collapse
|