Acute kidney injury in children with heart failure: any relationship to outcome?

Abstract

Background: Renal impairment at admission is common in heart failure and it is said to confer increased risk in mortality. This study was therefore set out to see if baseline renal dysfunction in children with congestive cardiac failure has any effect on outcome.
Materials and Method : Prospective study of cohort of children with heart failure were studied. Heart failure was defined using heart rate for age, respiratory rate for age and tender hepatomegaly. Acute kidney injury was based on absolute serum creatinine level > 0.5 mg/dl on admission. Age, gender, and out come we r e document ed. Laboratory results of electrolyte, urea , creatinine and clinical outcomes were also documented.
Results: One hundred and twenty patients were studied. The mean electrolytes were sodium 131.22± 5.67 meq/l, potassium 4.11±0.91 meq/l,chloride 97.11±13.17meq/l, bicarbonate 22±18.28meq/l, urea 48±55.07mg/dl and creatinine was 1.09±1.58mg/dl. Serum creatinine was severely elevated in 8.4% .Thirty percent of those with severely elevated serum creatinine died. Serum sodium (χ2=1.71,p=0.19), serum potassium (χ2 0.00 p=1.00),serum creatinine (p=0.58) did not significantly affect outcome.
Conclusion: This study showed that baseline serum potassium and creatinine are not determinants of outcome in children with heart failure associated with acute kidney injury.

Keywords: Heart failure, kidney injury, mortality, serum creatinine, serum potassium