Epidemiology data on the cost and outcomes associated with pediatric acute kidney injury

Pediatr Res. 2023 Oct;94(4):1385-1391. doi: 10.1038/s41390-023-02564-8. Epub 2023 Mar 22.

Abstract

Background: Hospitalized children with acute kidney injury (AKI) have not been extensively studied for clinical outcomes including hospital stay, the need for mechanical ventilation, mortality rates, and healthcare utilization. We hypothesize significant financial costs and increased morbidity and mortality associated with pediatric AKI.

Methods: This is a retrospective study of pediatric patients (age ≤18 years) included in the Kids' Inpatient Database (KID) between January 1, 2016, and December 31, 2021. The results of the data analysis were utilized for comparative testing between the AKI and non-AKI cohorts.

Results: The study included 4842 children [with AKI (n = 2424) and without AKI (n = 2418)]. The odds of mortality (p = 0.004) and mechanical ventilation (p < 0.001) were observed to be significantly higher among those with AKI as compared to those without AKI. Additionally, the median (IQR) duration of stay in the hospital (p < 0.001) and total cost (p < 0.001) were significantly higher among those with AKI vs. those without AKI.

Conclusions: AKI in children was associated with higher odds of mortality, longer duration of hospital stay, increased requirement of mechanical ventilation, and increased hospital expenditure. The scientific community can utilize this information to better understand the outcomes associated with this disease process in this patient population.

Impact: This article has thoroughly evaluated epidemiologic data associated with pediatric acute kidney injury (AKI) in hospitalized patients This study assesses mortality, hospital expenditure, and other factors to strengthen single-center and few multi-center studies and provides novel data regarding insurance and cost associated with pediatric AKI With increased knowledge of current epidemiology and risk factors, the scientific community can better understand prevention and outcomes in hospitalized children with AKI.

MeSH terms

  • Acute Kidney Injury* / complications
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / therapy
  • Adolescent
  • Child
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Respiration, Artificial*
  • Retrospective Studies
  • Risk Factors