A Study of Occurrence of Pre-Renal Azotemia in Children Admitted to Pediatric Intensive Care Unit (Code-T0195)

Introduction: Pre-renal azotemia (PRA), the most common cause of acute kidney injury (AKI) in critically ill children, arises from reduced renal perfusion and is potentially reversible with timely intervention. Early identification of PRA in pediatric intensive care unit (PICU) settings is crucial to prevent progression to intrinsic renal damage and improve outcomes.

Aims and Objectives:

1. To Study The Occurrence of Pre Renal Azotemia Among All The Children Admitted In Picu
2. To Study The Etiology of Children In Prerenal Azotemia

Methods: A prospective observational study was conducted in a tertiary care hospital. Children aged 1 month to 18 years admitted to the PICU with risk factors for PRA were included. Clinical and biochemical parameters, including serum creatinine, blood urea nitrogen, and urine output, were monitored. Patients were classified based on the KDIGO criteria for AKI. Outcomes, including the resolution of azotemia, progression to intrinsic AKI, and mortality, were analyzed.

Results: The study observed a 35% occurrence of PRA among PICU admissions. Hypovolemia, sepsis, and shock were the most common risk factors. With timely fluid resuscitation and hemodynamic support, 80% of cases showed recovery without progression to intrinsic AKI. However, delayed intervention correlated with worse outcomes, including higher mortality.

Conclusion: Pre-renal azotemia is a significant concern in critically ill children, emphasizing the need for early diagnosis and prompt intervention. This study highlights the importance of monitoring at-risk children to reduce morbidity and mortality.

Keywords: Pre-renal azotemia, pediatric intensive care, acute kidney injury, hypovolemia, sepsis, fluid resuscitation.