Mortality Predictors of Pediatric Acute Kidney Injury in Tertiary Care Hospital

Abstract Background: Acute kidney injury (AKI) is a serious complication that affects hospitalized patients, in both critically and noncritically ill pediatric populations and is associated with poor outcomes, including mortality. This study aims to identify the predictors associated with mortality in pediatric AKI patients. Subjects and Methods: We conducted a retrospective cohort study at the pediatric ward and intensive care unit Ngoerah Hospital, Bali. Data were collected retrospectively from medical records from July 2020 to January 2024. All children aged 1 month–<18 years old diagnosed with AKI, based on pediatric risk, injury, failure, loss, end-stage renal disease criteria, hospitalized and complete data, consecutively recruited into the study. Categorical data were presented as frequencies and percentages, whereas numerical data were presented as median and min–max values due to the nonnormal distribution of the data. We used Kolmogorov–Smirnov test to assess data normality. Bivariate and multivariate analysis was performed to identify predictors associated with mortality in pediatric AKI patients. The significance level (α) for this study was set at a P < 0.05. Results: A total of 139 children with AKI were evaluated, and a mortality rate was found in 36% of subjects. Multiorgan involvement and the need for dialysis are significantly associated with mortality in pediatric AKI patients with adjusted OR 2.8 (95% CI: 1.3–6.1; P = 0.009), and 4.1 (95% CI: 1.3–12.6; P = 0.013), respectively. Conclusion: Multiorgan involvement and the need for dialysis are significantly associated with mortality in pediatric AKI patients.