Acute Kidney Injury among the Hospitalised Children Treated with Aminoglycosides: A Prospective Observational Study

Introduction: Acute Kidney Injury (AKI) is frequently encountered among critically ill hospitalised children treated with Aminoglycosides (AGs). However, data regarding noncritically ill hospitalised children treated with AGs is lacking in the literature. Aim: To evaluate the occurrence of AKI among non-critically ill hospitalised children treated with AGs. Materials and Methods: The present prospective observational study was conducted in the Departments of Paediatrics and Paediatric Nephrology at the Government Medical College Srinagar, Jammu and Kashmir, India, from October 2018 to September 2020, on 142 children aged between one month and 18 years. These patients had normal renal function at admission and received at least one AG as in-hospital treatment for five days or longer. The rate of occurrence of AKI in the present study was evaluated using the paediatric Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria. Frequency and percentage were calculated for qualitative variables, while the relationship between variables was analysed using the Student’s t-test and Chi-square test. Results: Out of 142 children studied, 78 (54.92%) were males. Glomerular Filtration Rate (GFR) was estimated using the Schwartz formula, wherein 29 (20.4%) patients had AKI by AKIN criteria and 36 (25.3%) patients had AKI by pRIFLE criteria. The children with AKI were younger (mean age 23.8 months). Compared to a 12-hour AG dosing interval, patients who received a 24-hour dosing interval had a significantly lower rate of AKI (p<0.05). Conclusion: A substantial proportion of non-critically ill young children receiving daily multiple doses of AGs for five days or longer developed AKI.