ESPN 50th Annual Meeting

ESPN 2017


 
ACUTE RENAL FAILURE IN PEDIATRIC PATIENTS WITH SEPSIS
Enrika Ramoskaite 1 Diana Dobiliene 1 Sarunas Rudaitis 1 Jurate Masalskiene 1

1- The Lithuanian University of Health Sciences, Department of Pediatrics, Kaunas, Lithuania
 
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 yrs 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 yrs. 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 yrs 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 significantly more 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 is more prevalent.

3. N.meningitidis is the leading causative factor of multiple organ dysfunction including ARF.