Frequency of Acute Kidney Injury in Paediatric Patients Admitted With Sepsis in Ayub Teaching Hospital

Abstract

Background: Acute kidney injury (AKI) is a frequent and potentially life-threatening complication of pediatric sepsis and is associated with adverse outcome, including increased morbidity, extended hospitalization, and increased mortality. The reported frequency of sepsis-associated AKI varies widely, and regional data from Khyber Pakhtunkhwa are limited. This research aimed to assess the frequency of acute kidney injury among pediatric patients with sepsis in a tertiary care hospital. Objectives:  To assess the prevalence of acute kidney injury in pediatric population admitted as a case of sepsis in Ayub Teaching Hospital  Materials & Methods: This cross-sectional study was carried out in the Department of Pediatrics, Ayub Teaching Hospital, over six months period after approval of the research synopsis. The study population included pediatric patients from 1 month to 14 years of age admitted with sepsis. A sample size was calculated as 165 using WHO calculator for sample size, based on anticipated AKI proportion of 19%, with 95% confidence level and 6% absolute precision. A Consecutive non-probability sampling was used to enroll patients. Children with congenital renal anomalies or chronic kidney disease were excluded. Demographic data variables (age, gender, residence), urine output, and laboratory parameters including serum creatinine, urea, electrolytes, CRP, TLC, and blood culture were collected. Categorical variables were reported as frequencies and percentages, while continuous variables were summarized as mean ± SD or median (IQR) based on normality assessed by the Shapiro–Wilk test. Stratification was performed, and Fisher’s exact test was applied, with p ≤ 0.05 considered statistically significant. Results: The mean age of the patients was 22.3 ± 14.2 months. There were 13 (7.9%) patients with AKI with sepsis. The mean urine output was significantly reduced in patients with AKI as compared to those without AKI (0.36 ± 0.26 vs. 1.79 ± 0.72 ml/kg/hr). AKI was found to be statistically significant association with decreased urine output (p = 0.001), while no significant association was observed with gender. Conclusion: Acute kidney injury was found in a notable proportion of children admitted with sepsis and was strongly associated with reduced urine output. Early identification of renal involvement through close monitoring of urine output and renal function may help reduce complications and improve outcomes in pediatric sepsis.