This study uses very large numbers of linked electronic health records to answer important questions about sudden decline in kidney function in children. Amongst adults, a sudden decrease in kidney function, or acute kidney injury, is associated with increased risk of death, prolonged hospital stay, and risk of permanent kidney failure. Acute kidney injury is triggered by severe health events, such as infections, dehydration, or blood loss. There is very little information on how many children experience acute kidney injury in the United Kingdom, and what factors may increase a child’s risk of experiencing it. Knowing how big the problem is and who is most at risk would help in determining how much help is needed to prevent childhood acute kidney injury and how best to target that help.
We will identify all those children (aged 18 years or under on 31st March 2015 – the last day of linked primary care and hospital record data coverage) registered with general practices in the Clinical Research Practice Datalink (CPRD). We aim to investigate the awareness and coding of AKI in children over time, the risk factors for paediatric AKI, and death following AKI in children.
The study will have two phases: i) descriptive; and ii) analytical. In the descriptive phase, in all children hospitalised during the study period, we will compare the ratio of hospitalisations with an AKI record to other paediatric hospitalisations for each year of the study, and also compare the descriptive characteristics of those hospitalised with an AKI record to those without. In children meeting strict eligibility criteria we will calculate the annual overall age and sex adjusted incidence rate of paediatric AKI, and also stratify annual results by age and sex. In the analytical phase, we will conduct a nested case-control study comparing paediatric AKI cases with age, sex and GP practice matched controls to investigate the risk factors for AKI in children. To investigate outcomes following AKI we will compare childhood death rate in cases and controls.
Hospitalisation for acute kidney injury Frequency of childhood deaths
Dorothea Nitsch - Chief Investigator - London School of Hygiene & Tropical Medicine ( LSHTM )
Kathryn Mansfield - Corresponding Applicant - London School of Hygiene & Tropical Medicine ( LSHTM )
Alasdair Henderson - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Laurie Tomlinson - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Masao Iwagami - Collaborator - University of Tsukuba
HES Admitted Patient Care;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation