ESPN 54th Annual Meeting

ESPN 2022


 
Identifying Acute Kidney Injury – A Pilot Electronic-Alert System to identify AKI in at risk groups in a Tertiary Paediatric Hospital
COLIN HIGGINS 1 KATHRYN MULLAN 1 EMMA OHAGAN 1 MAIREAD CONVERY 1 GRACE MCCALL 1

1- ROYAL BELFAST HOSPITAL FOR SICK CHILDREN, BELFAST HEALTH AND SOCIAL CARE TRUST, NORTHERN IRELAND
 
Introduction:

Acute Kidney Injury (AKI) is an often under-recognised problem in the paediatric population. It is associated with increased morbidity and mortality along with an increased incidence of chronic kidney disease. Paediatric patients at high risk of AKI have been identified within the following clinical areas: Paediatric Intensive Care Unit (PICU), Haematology/Oncology and Cardiology. An AKI E-Alert system was subsequently piloted across the three aforementioned three areas to identify incidence of AKI in a tertiary paediatric hospital.

Material and methods:

All patients of the three clinical areas between 1st August and 31st October 2020 with an AKI stage 1 alert were included. The serum creatinine level (SCr) at the time of the alert was manually evaluated to assess true incidence of AKI using KDIGO classification. Baseline SCr was identified as the lowest SCr result on the Electronic Care Record system in the preceding 12 months or when this was unavailable, using the upper limit of the reference range for age.

Results:

Over a 3 month period there were 159 AKI stage 1 alerts affecting a total of 86 patients. Based on KDIGO classification, we identified 39 patients with AKI stage 1 (45%), 36 patients with AKI stage 2 (42%) and 7 patients with AKI stage 3 (8%). 4 patients were excluded as they were incorrectly highlighted as having had an AKI (5%). Haematology/Oncology patients most frequently developed true AKIs (51% ) and had the highest number of AKI stage 2-3s.

Conclusions:

The implementation of this pilot AKI E-Alert system provides crucial information regarding the incidence of inpatient AKI in high risk  paediatric patient groups. This will ultimately allow for early recognition and timely treatment of AKI, thus reducing the long term burden on paediatric renal health. This pilot also highlights the need for funding of an AKI service throughout the hospital.