Vinoy, GloriaSR, Shalini2025-10-142025-10-142024https://hdl.handle.net/20.500.14572/2671Gloria Vinoy Intern, Department of Paediatrics, Mysore Medical College and Research Institute, Irwin Road, Mysuru, Karnataka-570001, India. Shalini SR Assistant Professor Department of Paediatrics, Mysore Medical College and Research Institute, Irwin Road, Mysuru, Karnataka-570001, India.Abstract: Introduction: This study aims to investigate the incidence, etiology, risk factors, course, and outcomes of Acute Kidney Injury (AKI) in the Paediatric Intensive Care Unit (PICU). It also seeks to compare the pRIFLE (Paediatric Risk, Injury, Failure, Loss, and End-stage renal disease) and KDIGO (Kidney Disease: Improving Global Outcomes) criteria in terms of incidence and staging, and assess the relative diagnostic abilities of oliguria and serum creatinine as determinants. Methods: This was a cross-sectional study with AKI screening according to pRIFLE and KDIGO. All patients admitted to PICU for more than 24 hours were included. Relevant history, examination findings, and lab investigations were recorded after informed consent. Differences between AKI and non-AKI groups were analyzed using the independent t-test. Results: AKI incidence varied between 13.5% (pRIFLE) and 12.5% (KDIGO). The difference was statistically insignificant. Risk factors included nephrotoxic drugs, mechanical ventilation, and inotropes (p = 0.031, < 0.001, < 0.001). Mortality risk was 6.4 times higher in AKI. PICU stay was longer for AKI group (6.8 ± 3.9 days) compared to non-AKI (4.2 ± 2.6 days, p < 0.001). Urine output criteria identified AKI in 8.3% of patients not meeting serum creatinine criteria, while 23.3% had AKI based on serum creatinine only with normal urine output. Conclusions: AKI significantly increases mortality risk in PICU patients, with mechanical ventilation, nephrotoxic drugs, and inotropic support being key risk factors. Incidence rates vary by definition used, and there is poor congruence between serum creatinine and urine output in diagnosing AKI.en-USAcute kidney injuryAnuriaCritically illIntensive care unitMechanical ventilationOliguriaSerum creatinineArticle