Acute Kidney Injury in Children with Acute Gastroenteritis

This study was done in Children’s Medical Center Hospital affiliated with Tehran University of medical science, Tehran, Iran. The patients were 140 children who were admitted for gastroenteritis and we detected acute kidney injury in them. All of the patients were admitted and managed in the Emergency Department, and were evaluated for symptoms of AKI including dehydration, renal function tests, electrolytes, and urine output. The median age of the children with gastroenteritis and AKI was 2.5 years (ranging from 2 months to 12 years) and 78.6% of them were male. Acute kidney injury (AKI) was present in 116 (82.9%) patients at admission with 53 (37.8%) patients in the “failure” category (RIFLE). Twelve children had anuria and 54 patients had oliguria. At presentation, 24 patients (15%) had serum BUN levels between 30-75 and creatinine levels in the range of 0.9-2.1mg/dl. One patient had HUS that was excluded from this study. Seventy-six children had symptoms of severe dehydration and metabolic acidosis. After adequate fluid therapy, 30 children had polyuria of 6.4 (range 4-9) cc/kg/min. Twenty-three patients (16.4%) had hyponatremia and 41 patients (29.2%) had hypernatremia. Nine children (6.4%) suffered from hypokalemia. Some children had received ORS at home. All of them were managed in the emergency ward and discharged with normal GFR without any electrolyte abnormalities. The patients were fallowed for 3-6 months and all of them had normal renal function at the end of the study. Early diagnosis and urgent management of gastroenteritis and dehydration can prevent AKI.