Abstract
Objective: To establish the incidence, severity, and short-term consequences of AKI in pediatric patients with acute gastroenteritis by applying the pediatric-adapted RIFLE criteria and to identify related electrolyte abnormalities and urine output patterns.
Methods: The retrospective (observational) study was performed between February 2025 and June 2025 in emergency department of Jinnah Sindh Medical College, Karachi, Pakistan. This study was conducted on 305 children aged 12 months to 12 years with acute gastroenteritis who presented to a tertiary emergency department from Feb 2025 to June 2025. Clinical, biochemical, and urine output data were collected. AKI was defined as those meeting the “Failure” category of the RIFLE classification. Outcomes included incidence of AKI, electrolyte disturbances, urine output patterns, and renal recovery over a 3–6 month follow-up.
Results: AKI was diagnosed in 109 children (35.7%), anuria and oliguria were seen in 3.9% and 17.7% of the patients, respectively. There was elevated BUN (>100 mg/dL) in 18 patients and creatinine levels between 0.9 and 5.4 mg/dl. Electrolyte imbalances were hyponatremia (n=8), hypernatremia (n=5), and hypokalemia (n=8). Younger children who had oral rehydration solution (ORS) at home tended to have less severe AKI. All patients successfully recovered with normalized renal function within 3–6 months, and none progressed to chronic kidney disease.
Conclusion: AKI was a frequent and serious complication of pediatric gastroenteritis, occurring in 35.7% of children in the RIFLE "Failure" category. Early detection, fluid resuscitation, and supportive therapy allowed complete renal recovery.
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