#2686 15-year temporal changes in rates of acute kidney injury among children: a population-based cohort study

Abstract Background and Aims Acute kidney injury (AKI) is defined as a sudden decrease in kidney function and is associated with increased morbidity and mortality. The reported prevalence of AKI among hospitalized children is approximately 30% but varies widely depending on population characteristics and method used to define AKI. Little is known about the incidence of community-acquired AKI and potential temporal changes in AKI incidence among children. Such information is important for AKI prevention, resource allocation and future research. In this study, we aimed to examine overall temporal changes in the rate of hospital- and community-acquired pediatric AKI and to describe associated changes in potential underlying risk markers. Method In this population-based cohort study, we included children aged 0-17 years from 1 January 2007 to 31 December 2021 in Denmark. In 2021, the Danish population consisted of 1,168,222 children. We obtained clinical plasma creatinine measurements from the Danish laboratory databases to identify all KDIGO-defined AKI episodes within the study period. For each child, only the first AKI episode per year was included and we defined an AKI episode as a period of 30 days. AKI was defined as community-acquired if the plasma creatinine at time of AKI was taken in the outpatient clinic or the first day of admission/acute setting. We estimated the annual AKI rate as first AKI episodes in a year among children residing in an area covered by the laboratory databases divided by the number of children residing in this area in the same year. Unadjusted rates as well as sex- and age-standardized rates was reported. Using Danish medical databases, we identified potential risk markers for AKI, such as use of nephrotoxic medication, surgery, sepsis, and perinatal factors including low birth weight and preterm birth. Results In total, 14,262 children contributed with 16,492 AKI episodes. The average annual rate of AKI was 149 per 100,000 children and was stable throughout the study period (figure). Of the AKI episodes, 10,921 (66.2%) were community-acquired and 12,714 (77.1 %) were stage 1 AKI. No major changes were seen in the prevalence of risk makers among AKI episodes. Conclusion The rate of AKI among Danish children was stable from year 2007 to 2021 and potential risk markers were largely similar over time.