Profile of renal conditions among pediatric emergency patients

Renal diseases are frequently seen in the pediatric emergency department (ED), and usually, they are associated with morbidity and mortality if not early detected and properly managed. While acute kidney injury (AKI) can result from intrinsic kidney disease, many acute (nonrenal) conditions may be associated with AKI. In addition, children with chronic kidney disease (CKD) may also present to the ED with acute symptoms or complications.

To evaluate patients presenting to the ED with renal affection, their etiology, management, and outcome.

This is a prospective descriptive study on 100 patients presented to Cairo University Pediatric ED with renal affection, from Jan to June 2023. Clinical data were collected including presenting manifestations, vital signs, clinical assessment, laboratory and radiological investigations, and also their plan of management or interventions needed and their outcome.

Seventy-three percent of the patients had underlying CKD, and they presented mostly with acute complications as urinary tract infections (20%), severe anemia (25%), disturbed conscious level (10%), convulsions (12%), and hypertensive emergency (18%). Of the AKI patients (27%), 18% had underlying renal diseases, and 9% had multisystem affection. All of our patients received conservative management, 74 patients were admitted at the hospital, 24 patients needed ICU admission, 14 patients did peritoneal dialysis, 6 did hemodialysis, and only 1 patient needed continuous renal replacement therapy. Mortality was observed in only 2% of our patients.

Patients with renal conditions either AKI or CKD present to the ED with various acute conditions. Proper identification and provision of required services is important for a satisfactory outcome.